Malignant hypertension due to an aldosterone producing adrenal adenoma

Malignant hypertension in Conn's syndrome is rare. We report an 18 year old boy who presented with visual and renal impairment due to malignant hypertension which subsequently proved to be secondary to an aldosterone secreting adrenal adenoma. Diagnosis was delayed in this patient as plasma renin concentrations (PRC) were not invariably low and it is emphasized that suppression of PRC is not always a feature of primary hyperaldosteronism. The diagnosis of primary hyperaldosteronism is only excluded adequately by the demonstration of suppression of aldosterone secretion.