title: Spontaneous remission of idiopathic aldosteronism after long-term treatment with spironolactone: results from the German Conn's Registry.
abstract: BACKGROUND
  Primary aldosteronism (PA) is mainly caused by aldosterone-producing adenoma and idiopathic bilateral adrenal hyperplasia (IHA). Recently, spontaneous resolution of IHA has been described.
  
  
  OBJECTIVE
  We aimed to determine the frequency of spontaneous remission of PA during long-term treatment with mineralocorticoid receptor (MR) antagonists.
  
  
  METHODS
  Thirty-seven patients of the Munich PA registry with IHA treated by MR antagonists were investigated. The patients were identified retrospectively by chart review and prospectively assessed by clinical and biochemical means.
  
  
  METHODS
  Complete remission of IHA was defined as normal aldosterone to renin ratio (ARR), normal suppression test and normalization of hypokalaemia in the presence of normal blood pressure. Partial remission was defined as normalization of normal ARR, normal suppression test and normalization of hypokalaemia in the presence of persistent hypertension.
  
  
  RESULTS
  The mean period of MR antagonist treatment was 5·8 ± 0·7 years in the patients. We identified two of 37 (5·4%) patients with spontaneous remission: one with complete remission and one with partial remission.
  
  
  CONCLUSIONS
  Remission of IHA in PA may occur in some patients after long-term mineralocorticoid antagonist treatment.
authors.affiliation: Medizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Fischer
authors.forename: Felix
authors.initials: F
authors.lastname: Beuschlein
authors.forename: Christoph
authors.initials: C
authors.lastname: Degenhart
authors.forename: Philip
authors.initials: P
authors.lastname: Jung
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.forename: Martin
authors.initials: M
authors.lastname: Reincke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D013148:Spironolactone / Q000627:therapeutic use*
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone