A 36-Year-Old Woman With an Unexpected Cause of Hypokalemia

A 36-year-old woman with diabetes and polycystic ovary disease experienced recurrent lower limb weakness and hypokalemia, along with symptoms of metabolic syndrome. Upon further investigation, she was diagnosed with Cushing disease due to an ACTH-dependent pituitary macroadenoma. After undergoing transsphenoidal resection and stereotactic radiosurgery on the tumor, followed by hormone replacement and glycemic control, she no longer experienced hypokalemia episodes, lost 10 kg, and achieved adequate glycemic control. This case emphasizes the need to consider Cushing disease as a possible diagnosis in cases of refractory hypokalemia, even without clear signs of hypercortisolism.