An Unusual Cause of Hypokalemia in an Elderly Man with Hypertension

SummaryHypokalemia in the elderly usually results from gastrointestinal loss or the use of diuretics. However, primary aldosteronism should be considered in hypertensive patients with metabolic alkalosis and unexplained hypokalemia with hyperkaliuresis. We report a 63 year-old hypertensive man with such metabolic findings. The transtubular potassium concentration gradient and serum aldosterone level were higher than normal. Abdominal computed tomography showed bilaterally enlarged adrenal glands, and a nuclear medicine study supported the diagnosis of bilateral adrenal hyperplasia.