Effects on muscle electrolytes of potassium and magnesium infusions, spironolactone medication and operation in a case of primary aldosteronism.

Serum and muscle electrolytes were determined in a case of primary aldosteronism before and after potassium and magnesium infusions as well as spironolactone treatment and following surgery. Repeated potassium infusions resulted in a transient normalization of the muscle potassium (K/m), followed within 3-4 days by a return to the previously low K/m. Magnesium infusions did not give any increase in muscle magnesium (Mg/m). On the contrary, there was a decrease in Mg/m concomitant with a decrease in K/m. Treatment with spironolactone for one month was followed by a normalization of both serum and muscle electrolytes. Following surgery the serum potassium and K/m remained normal, but the serum magnesium (Mg/s) and Mg/m showed a decrease to subnormal values. Despite the initial findings of normal Mg/s and Mg/m as well as excretion of more than 80% of the i.v. magnesium dose, this may indicate that there was a magnesium deficiency in the skeletal pool.