10 April 2021
: Case report 
Hypokalemia-Induced Rhabdomyolysis Caused by Adrenal Tumor-Related Primary Aldosteronism: A Report of 2 Cases
Unusual clinical course, Challenging differential diagnosis
Chung-Tso Chen1ABCDEF*, Yen-Chieh Wang12ABD, Chih-Ming Lin1ABCDFDOI: 10.12659/AJCR.929758
Am J Case Rep 2021; 22:e929758
Table 1. Laboratory data on admission and endocrine data.
| Case 1 | Case 2 | Reference range | ||
|---|---|---|---|---|
| WBC | 11150 | 13600 | 4000~10 000 | /uL |
| RBC | 4.39 | 4.65 | 4.70~6.10 | 10/uL |
| Hb | 13.3 | 13.4 | 14.0~18.0 | g/dL |
| Hct | 36 | 37.6 | 42.0~52.0 | % |
| PLT | 208 | 289 | 130~400 | 10/uL |
| BUN | 11 | 15 | 8~25 | mg/dL |
| Cr | 1.15 | 0.85 | 0.63~1.30 | mg/dL |
| GOT | 218 | 126 | 5~35 | IU/L |
| GPT | 100 | 42 | 5~35 | IU/L |
| T. Bil | 1.4 | 0.5 | 0.2~1.5 | mg/dL |
| CPK | 15930 | 1629 | 30~223 | IU/L |
| Myoglobin | >3000 | 838.1 | 28.0~72.0 | ng/mL |
| Na | 141 | 142 | 135~145 | mmol/L |
| K | 2.1 | 1.9 | 4.1~5.6 | mmol/L |
| Osm | 288 | 296 | 275~295 | mOsm/kg |
| Glu | 163 | 70~140 | mg/dL | |
| PH | 7.505 | 7.445 | 7.35~7.45 | |
| pO2 | 45.0 | 42.8 | 83.0~108.0 | mmHg |
| pCO2 | 43.0 | 52.0 | 35.0~45.0 | mmHg |
| HCO3 | 33.2 | 34.9 | 21.0~28.0 | mmol/L |
| BE | 10.1 | 10.9 | mmol/L | |
| Microscopic RBC | 0~3 | 10~19 | 0~5 | /HPF |
| Microscopic WBC | 0~5 | 0~5 | 0~5 | /HPF |
| Ep. cell | 0~5 | 0~5 | 0~5 | /HPF |
| Cast | – | – | – | /LPF |
| Crystal | – | – | – | /HPF |
| Bacteria | – | +/– | – | /HPF |
| Glucose | – | – | – | |
| Bilirubin | – | – | – | |
| Ketone body | – | – | – | |
| Specific gravity | 1.006 | 1.012 | 1.003~1.035 | |
| OB | 2+ | 3+ | – | |
| PH | 8.5 | 8.5 | 5.0~8.0 | |
| Protein | +/– | 30 | – | mg/dl |
| Urobilinogen | 0.2 | 0.2 | 0.2~1.0 | E.U/dl |
| Nitrite | – | – | – | |
| Leukocyte | – | – | – | |
| Renin | 1.3 | 1.1~20.2 | pg/mL | |
| PRA | <0.07 | <0.07 | 0.32~1.84 | ng/mL/hr |
| Aldosterone | 38.8 | 13.6 | 6.8~17.3 | ng/dL |
| PAC/PRA ratio (ARR) | >554.28 | >194.28 | <30 | ng/dl: ng/ml/h |
| ACTH (8AM) | 14.0 | 17.0 | 9.0~52.0 | pg/ml |
| T3 | 68.7 | 73.6 | 60.0~190.0 | ng/dl |
| Free T4 | 1.68 | 1.14 | 0.56~1.80 | ng/dl |
| TSH | 0.59 | 1.61 | 0.25~4.0 | uIU/ml |
| Cortisol | 5.2 (random) | 16.9 (8AM) | 5.0~20.0 | ug/dl |