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An unexpected rise in plasma aldosterone to furosemide-upright test in primary aldosteronism due to aldosterone
C Shigemasa1, T Kouchi, A Yoshida
1First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Abstract:
This paper documents an unexpected rise in plasma aldosterone concentration (PAC) to the furosemide-upright test despite a decrease in adrenocorticotropin (ACTH) by dexamethasone, and an unresponsiveness in plasma renin activity to this stimulus in a patient with aldosterone producing adenoma. Furthermore, this patient showed an appropriate response in PAC to a rapid ACTH test, and an insensitivity in PAC to angiotensin-II (Ang-II) infusion. Other factor(s) besides ACTH or Ang-II may play a role in the plasma aldosterone response to ambulation after intravenous furosemide administration in patients with primary aldosteronism.