Diagnosis of adenomatous primary aldosteronism in a patient with severe hypertension.
BACKGROUND
A 27-year-old woman presented to her primary-care physician with severe hypertension after complaining of fatigue over the preceding months. She was otherwise asymptomatic. She was referred to a hypertension clinic and was found to be hypokalemic. She was immediately commenced on amlodipine, with atenolol added 2 weeks later. After 4 weeks of this drug therapy, her hypertension persisted and investigations to exclude secondary causes of hypertension were performed.


METHODS
Aldosterone and renin levels were measured under controlled conditions and the results expressed as an aldosterone-to-renin ratio. CT of the adrenal glands was also performed.


METHODS
Adenomatous primary aldosteronism (Conn's syndrome).


RESULTS
The patient was initially treated with spironolactone before undergoing a laparoscopic left adrenalectomy.
Freel
E Marie
EM
University of Glasgow, Glasgow, UK.
Connell
John M C
JM
D000311:Adrenal Glands / Q000000981:diagnostic imaging; D018246:Adrenocortical Adenoma / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000450:Aldosterone / Q000097:blood / Q000627:therapeutic use; D000465:Algorithms; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D007008:Hypokalemia / Q000175:diagnosis; D012083:Renin / Q000097:blood; D014057:Tomography, X-Ray Computed
D000450:Aldosterone; D012083:Renin