title: [Unilateral autonomous aldosterone production in hyperaldosteronism suppressible by dexamethasone].
abstract: A 21-year-old woman with weight loss, palpitations and facial flush was found to have hypertension (up to 200/130 mm Hg) and mild hyperkalaemia (3.4 mmol/l). Extensive diagnostic tests revealed hyperaldosteronism with contrast storing in the right adrenal gland on scintigraphy after injection of dexamethasone (2 mg daily for one week). The hyperaldosteronism could not be suppressed by dexamethasone. Analysis of venous blood separately from each side pointed to aldosterone production in the right adrenal (right renal vein: 80 ng/dl, drainage area of the right adrenal vein: 114 ng/dl, left renal vein: too low to measure). The right adrenal gland was removed. No adenoma was found histologically. After the operation the aldosterone level was reduced and the blood pressure transiently fell. But both had risen again after 3 months. Renewed tests revealed dexamethasone-remediable hyperaldosteronism. On treatment with hydrocortisone (15-5-5 mg) and 50 mg metoprolol the patient became normotensive without any other medication.
authors.affiliation: Medizinische Poliklinik, Universität Würzburg.
authors.forename: F
authors.initials: F
authors.lastname: Jakob
authors.forename: J
authors.initials: J
authors.lastname: Seufert
authors.forename: D
authors.initials: D
authors.lastname: Haack
authors.forename: K
authors.initials: K
authors.lastname: Schröder
authors.forename: J
authors.initials: J
authors.lastname: Ludwig
authors.forename: J
authors.initials: J
authors.lastname: Rendl
authors.forename: P
authors.initials: P
authors.lastname: Vecsei
mesh_terms: D000305:Adrenal Cortex Hormones / Q000097:blood; D000328:Adult; D000450:Aldosterone / Q000378:metabolism*; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D006929:Hyperaldosteronism / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D000450:Aldosterone; D003907:Dexamethasone; D006854:Hydrocortisone
vernacular_title: Einseitige autonome Aldosteronproduktion bei Dexamethason-supprimierbarem Hyperaldosteronismus.