Hypokalemic myopathy in arterial hypertension

: Three cases of arterial hypertension and severe hypokaliemia are reported; in two cases an acute rhabdomyolisis was also observed. The syndrome was iatrogenic in two cases depending on the licorice eating and the combined use of diuretics and a 9-alpha-fluoroprednisolone-containing nasal spray in one patient, and on a long-term use of the same nasal decongestant in the other. In the patient 2 the persistence of low PRA and aldosterone levels seems to indicate an excess of mineralcorticoid activity other than aldosterone. The syndrome of factitious mineralcorticoid excess should, therefore, be considered in the differential diagnosis of arterial hypertension with hypokaliemia; the risks of a long-term administration of steroid-containing nasal sprays, responsible of serious side effects, should also be stressed.