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Asymptomatic normotensive primary aldosteronism. Case report.

M Matsunaga, A Hara, T S Song

    Hypertension (Dallas, Tex. : 1979)
    |March 1, 1983
    PubMed
    Summary

    Primary aldosteronism can occur without hypertension. This case highlights an incidentally discovered adrenal tumor causing hypokalemia, emphasizing that high blood pressure is not always present.

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    Area of Science:

    • Endocrinology
    • Nephrology
    • Oncology

    Background:

    • Primary aldosteronism is a condition characterized by excessive aldosterone production.
    • It is often associated with hypertension and hypokalemia.

    Observation:

    • A 30-year-old woman presented with incidentally discovered hypokalemia (2.6 mEq/liter) during a routine checkup.
    • She had no history of hypertension or other typical symptoms of primary aldosteronism.

    Findings:

    • Biochemical tests revealed suppressed plasma renin activity (PRA) and elevated plasma aldosterone levels.
    • Imaging studies, including adrenal scintigraphy, CT, and adrenal venography, identified a functioning right adrenal tumor.
    • Adrenal venous catheterization confirmed lateralized aldosterone hypersecretion, indicative of an aldosteronoma.

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    Implications:

    • Surgical removal of the benign adenoma corrected the biochemical abnormalities (hypokalemia and hormonal imbalances).
    • However, the patient's blood pressure remained unchanged, suggesting that hypertension is not a mandatory clinical feature of primary aldosteronism.
    • This case underscores the importance of considering primary aldosteronism in patients with unexplained hypokalemia, even in the absence of hypertension.