[Hypertension, hyperpotassemia and normal glomerular filtration (Gordon's syndrome): a case report].
We describe a case of a 26 year old patient affected by a rare syndrome characterized by hyperkalemia, arterial hypertension and normal glomerular filtration rate (Gordon's syndrome), probably due to a renal tubular defect in the reabsorption of sodium or chloride. The patient, who had hyperkalemia since the age of 4 years, was referred to our Centre because of hypertension not well controlled with antihypertensive treatment. After drug therapy wash-out, we confirmed the existence of hypertension (180/100 mm Hg; ambulatory BP monitoring: 24-h mean BP = 151/91 mm Hg; 7 am-11 pm = 157/95; 11 pm-7 am: 133/82) and blood and urine tests showed hyperkalemia (6.6 mEq/L), hyperchloremia (115 mEq/L), mild metabolic acidosis (pH = 7.35, HCO3 = 19 mEq/L), low levels of plasma renin activity ( < 0.2 ng/ml/h), slight increase of plasma (1.08 nM/L) and daily urine aldosterone (129 nM) and normal serum creatinine (1.1 mg/dl) and glomerular filtration rate (91 ml/min). These data allowed to exclude the presence of renal failure and hyporeninemic hypoaldosteronism, which are the most common diseases with hypertension and hyperkalemia, and suggested the diagnosis of Gordon's syndrome. After 1 month of treatment with chlorthalidone (12.5 mg o.i.d) we observed the normalization of BP (130/80 mm Hg; ambulatory BP monitoring: 24-h BP: 132/76 mm), serum potassium (5,1 mEq/L) and the other blood and urine tests. These results were confirmed 6 months later and at present the patient has good clinical conditions.
Fortini
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Centro per lo Studio Della Ipertensione Arteriosa, i Medicina Interna, Nuovo Ospedale San Giovanni di dio, Firenze.
Nenci
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Laureano
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R
Cappelletti
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C
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002752:Chlorthalidone / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D015716:Electrocardiography, Ambulatory; D005919:Glomerular Filtration Rate; D006801:Humans; D006947:Hyperkalemia / Q000150:complications* / Q000175:diagnosis; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D011188:Potassium / Q000097:blood; D013577:Syndrome
D000959:Antihypertensive Agents; D004232:Diuretics; D002752:Chlorthalidone; D011188:Potassium
Ipertensione, iperpotassiemia e normale filtrato glomerulare (sindrome di Gordon): descrizione di un caso.