Primary hyperaldosteronism

Abstract

Primary aldosteronism is caused by autonomous production of aldosterone by the adrenal cortex (due to hyperplasia, adenoma, or carcinoma). It is the cause of most common secondary form of arterial hypertension. The most common causes (90%) of primary aldosteronism are aldosterone producing adenomas and bilateral adrenal hyperplasia. Surgery is the recommended treatment for aldosterone producing adenomas. A 48-year-old woman, known hypertensive, was admitted with severe and refractory hypokalemia, ECG abnormalities and metabolic alkalosis. Serum aldosterone to PRA (plasma renin activity) ratio was high and CT scan of abdomen revealed an adrenal adenoma. She underwent left laparoscopic adrenalectomy and histopathology confirmed the presence of adrenal adenoma. Both hypertension and hypokalemia resolved after surgery. High degree of suspicion is required to recognize this disorder early and to arrange proper diagnostic tests and treatment, to avoid missing curable hypertension

Keywords

• Hypertension
• hypokalemia
• primary aldosteronism
• Conn’s syndrome