1. A 30-year-old woman had a 7-year history of hypertension and hypokalemia. Her blood pressure was not well controlled despite a four-drug program that included a calcium channel blocker, ACE-inhibitor, thiazide diuretic, and a β-adrenergic blocker. To correct her hypokalemia, she took 420 mEq of potassium per day. The case-detection test for primary aldosteronism was positive, with a plasma aldosterone concentration (PAC) of 34 ng/dL and low plasma renin activity (PRA) at less than 0.6 ng/mL/h (PAC-PRA ratio >56). The confirmatory test for primary aldosteronism was also positive, with 24-hour urinary excretion of aldosterone of 77 μg on a high-sodium diet (urinary sodium, 205 mEq/24 h). A. Adrenal CT axial image showing a 15-mm low-density mass (arrow) within the right adrenal gland. She underwent laparoscopic right adrenalectomy. B. Right adrenal gland (6.2 g, 6.1 cm × 3.7 cm × 1.4 cm) with a 1.8-cm cortical adenoma arising from the surface. C. Cut sections of the yellow adrenal cortical adenoma forming a 1.8 cm × 1.7 cm × 1.3 cm nodule. The postoperative plasma aldosterone concentration was less than 1.0 ng/dL. Hypokalemia was resolved. Four years after surgery, her blood pressure was normal without the aid of antihypertensive medications.
Source: Endocrine Hypertension, Greenspan's Basic & Clinical Endocrinology, 10e
Citation: Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology, 10e; 2017 Available at: Accessed: October 11, 2017
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