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Severe Symptomatic Hyperkalemia in an Adrenalectomized Woman Due to Enhanced Mineralocorticoid Requirement

Ann Intern Med. 1967;66(6):1197-1203. doi:10.7326/0003-4819-66-6-1197
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The development of hyperkalemic neuromyopathy in untreated Addison's disease is unusual. The common picture of addisonian crisis is dominated by the signs and symptoms of hypovolemia and circulatory collapse. Moderate hyperkalemia occurs, but neuromuscular complaints attributable to the hyperkalemia can rarely be detected. With cortisone and mineralocorticoid treatment correction of the electrolyte disturbance is prompt. With the addition of potent mineralocorticoids such as fluorohydrocortisone (50 to 100 μg/day) to cortisone replacement (25 to 37.5 mg/day), serious disturbances of electrolyte levels in the plasma are rarely encountered, even when patients enter the hospital in acute collapse secondary to an intercurrent infection.


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