Control of plasma aldosterone in a patient with Conn's syndrome before and during spironolactone medication.
In a patient suffering from Conn's syndrome analysis of short-time fluctuations of plasma aldosterone, plasma cortisol and plasma renin activity were performed before and after a 9-months therapy period with spironolactone. Under the former conditions aldosterone was secreted episodically and a highly significant correlation was found between plasma aldosterone and plasma cortisol (r=0.817, p is less than 0.001) while plasma renin activity was undetectable (is less than 0.16 ng/ml/3hr). Following a 9-month therapy with spironolactone episodic secretion of aldosterone and the significant correlation between aldosterone and cortisol persisted (r=0.819, p less than 0.001) in the presence of an abnormally high plasma renin activity. First when the secretion of ACTH was suppressed by dexamethasone a weak correlation was found between renin activity and aldosterone (r=0.517, p is less than 0.05). Our results show that both before and after a 9-months therapy with spironolactone episodic aldosterone release of an aldosterone producing adrenal adenoma was mediated through ACTH and that endogeneous angiotensin II had no or only little influence.
D000236:Adenoma / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000450:Aldosterone / Q000097:blood* / Q000378:metabolism; D000804:Angiotensin II / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006929:Hyperaldosteronism / Q000188:drug therapy*; D008875:Middle Aged; D012083:Renin / Q000097:blood; D012636:Secretory Rate / Q000187:drug effects; D013148:Spironolactone / Q000494:pharmacology* / Q000627:therapeutic use
D000804:Angiotensin II; D013148:Spironolactone; D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D012083:Renin; D006854:Hydrocortisone