Approach to the normotensive patient with aldosterone-producing adenoma
10.3760/cma.j.issn.1000-6699.2012.02.019
- VernacularTitle:血压正常醛固酮瘤的临诊应对
- Author:
Huiyun LIU
;
Zhiqing TANG
;
Jin DU
;
Xianling WANG
;
Guoqing YANG
;
Jianming BA
;
Jinzhi OUYANG
;
Weijun GU
;
Qinghua GUO
;
Lijuan YANG
;
Zhaohui Lü
;
Jingtao DOU
;
Yiming MU
- Publication Type:Journal Article
- Keywords:
Normotension;
Primary aldosteronism;
Adrenal adenoma
- From:
Chinese Journal of Endocrinology and Metabolism
2012;28(2):160-163
- CountryChina
- Language:Chinese
-
Abstract:
A 31-year-old male normotensive patient with aldosterone-producmg adenoma complained of thirst,polydipsia,polyuria,and periodical paraplegia.The diagnosis is raised by signs of hypokalemia.Despite the lack of hypertension,primary aldosteronism was confirmed by persistent hypokalemia,increased urinary potassium,increased urinary and plasma aldosterone levels and suppressed plasma rennin activity (PRA).The blood pressure profile was studied by ambulatory monitoring,and the mean blood pressure of 24h was normal and the circadian rhythm remained normal. Surgical removal of the histologically typical aldosterone-producing adenomas normalized the kalemia.The patient had a marked fall in blood pressure with mean values of 21/17 mm Hg ( diurnal and nocturnal blood pressure were 19/17 and 22/17 mm Hg respectively)and recovery of normal urinary and plasma aldosterone levels and PRA 6 weeks after surgery.This suggests that excess serum aldosterone induced relative hypertension in those patients whose blood pressure was spontaneously very low.Our observations call for primary hyperaldosteronism assay in patients with hypokalemia and renal potassium leakage.
