Hypokalaemic paralysis as a presenting feature of primary aldosteronism

A woman in her 30s presented with acute flaccid paraparesis secondary to severe hypokalaemia. She had a known history of hypertension controlled on amlodipine and bisoprolol. Biochemical workup revealed metabolic alkalosis, renal potassium loss, suppressed plasma renin activity and markedly elevated aldosterone levels. CT imaging identified a left adrenal adenoma consistent with an aldosterone-producing adenoma. The patient underwent laparoscopic adrenalectomy, after which she no longer required antihypertensive medication and maintained normal serum potassium. This case highlights a reversible but often under-recognised cause of secondary hypertension presenting with hypokalaemic paraparesis.