The Big Man speaks on Liddle-Man’s!

Today Dr Grovenburg (the “big man”) presented a show stopping case of impressive hypokalemia (K 1.6) in an older woman who was also recently found to be hypertensive and demonstrated a significant metabolic alkalosis.

What a great presentation for the classic triad often seen in mineralocorticoid excess of: 1) Hypokalemia 2) Hypertension and 3) Metabolic Alkalosis.

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The causes of mineralocorticoid excess are further broken down, as seen in the table below.

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In the case of our patient, who was found to have LOW renin and LOW aldosterone, the jury is still out if her diagnosis is Apparent Mineralocorticoid Excess or Liddle’s Syndrome. Worth note, licorice can also do this, but not your average twizzlers… the real kind. Below is a nice compare and contrast of these two conditions (well three conditions—there is a shout out to licorice).

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