Unrecognized primary aldosteronism may confound outcomes in adrenal Cushing's syndrome

Patients with adrenal Cushing's syndrome may also have undiagnosed primary aldosteronism-a condition that causes high blood pressure and low potassium. Both hormone problems can arise from the same adrenal tumor. In a Colombian registry study of 130 patients, none of the 22 with adrenal Cushing's syndrome were screened for aldosterone excess before surgery. Because high blood pressure and low potassium occur in both conditions, some postoperative problems may be due to unrecognized aldosterone excess rather than cortisol alone. We suggest routine screening for primary aldosteronism in patients with adrenal Cushing's syndrome who have high blood pressure, as recommended by current guidelines, to enable more accurate diagnosis and personalized treatment.