Acute Quadriparesis: A Rare Presenting Manifestation of an Adrenal Tumor

Abstract

Acute quadriparesis is caused by severe and sudden weakness of all four limbs, which is a distressing clinical presentation that demands immediate and comprehensive investigation. This case report presents a unique instance of acute quadriparesis secondary to an adrenal tumor. A 54-year-old female presented with acute weakness in her upper and lower limbs over six hours without a prior history of fever, convulsions, or other systemic symptoms. Laboratory evaluations revealed significant hypokalemia, prompting further investigation. Differential diagnoses such as Guillain-Barré syndrome, demyelinating lesions, and myopathy were systematically ruled out through clinical evaluation and diagnostic testing. The patient's hypokalemia was aggressively managed with intravenous potassium replacement, leading to significant improvement in muscle strength. Radiological imaging revealed a hyperenhancing lesion in the left adrenal gland, consistent with an adrenal tumor. Elevated serum aldosterone levels supported the diagnosis of hyperaldosteronism. The patient's condition stabilized with intravenous potassium and antihypertensive medications, and a laparoscopic adrenalectomy was performed to remove the adrenal tumor. Postoperatively, the patient's blood pressure and electrolyte levels normalized, and she experienced a full recovery of muscle strength. This case highlights the importance of considering endocrine disorders in the differential diagnosis of acute quadriparesis and underscores the need for a comprehensive diagnostic approach, including routine electrolyte assessments, hormonal evaluations, and thorough imaging studies. Effective management involving prompt identification and treatment of underlying causes is critical for optimal patient outcomes. This case contributes valuable insights into the diverse clinical manifestations of adrenal tumors and the importance of early and accurate diagnosis.

Keywords: adrenal tumor; elevated serum aldosterone; endocrine disorders; hypokalemia; hypokalemic quadriparesis.