Primary hyperaldosteronism: a case of unilateral adrenal hyperplasia with contralateral incidentaloma

BMJ Case Reports 2016; doi:10.1136/bcr-2016-216209
  • CASE REPORT
  1. Sujit Vakkalanka1,
  2. Andrew Zhao1,
  3. Mohammed Samannodi2

+Author Affiliations


  1. 1University at Buffalo, Buffalo, New York, USA

  2. 2Department of Medicine, Buffalo, New York, USA
  1. Correspondence toDr Mohammed Samannodi, samannodi@gmail.com
  • Accepted 28 June 2016
  • Published 14 July 2016

Summary

Primary hyperaldosteronism is one of the most common causes of secondary hypertension but clear differentiation between its various subtypes can be a clinical challenge.

We report the case of a 37-year-old African-American woman with refractory hypertension who was admitted to our hospital for palpitations, shortness of breath and headache. Her laboratory results showed hypokalaemia and an elevated aldosterone/renin ratio. An abdominal CT scan showed a nodule in the left adrenal gland but adrenal venous sampling showed elevated aldosterone/renin ratio from the right adrenal vein. The patient began a new medical regimen but declined any surgical options.

We recommend clinicians to maintain a high level of suspicion to consider the less common subtypes of primary hyperaldosteronism, especially given the fact that the management greatly varies.

From http://casereports.bmj.com/content/2016/bcr-2016-216209.short?rss=1

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