Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Primary aldosteronism with an aldosterone-producing adenoma and contralateral adrenal hyperplasia: A case report

양측성 부신비대와 알도스테론 생성 선종이 동시에 발현된 증례

  • Park, Hye Won (Jeju National University School of Medicine) ;
  • Lee, Sang Ah (Department of Endocrinology and Metabolism Jeju National University School of Medicine)
  • 박혜원 (제주대학교 의학전문대학원) ;
  • 이상아 (제주대학교 의학전문대학원 내분비대사내과)
  • Received : 2020.07.17
  • Accepted : 2020.08.20
  • Published : 2020.08.31
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Abstract

Primary aldosteronism has been found more often among patients with hypertension. Primary aldosteronism can be caused by an aldosterone-producing adenoma, bilateral adrenal hyperplasia, or rarely by an adrenal carcinoma. An initial diagnostic test for aldosteronism is a measurement of the plasma renin activity and aldosterone concentration. For example, up to 20% of patients with hypertension showed increased plasma aldosterone concentration/renin activity ratio. If surgery is planned, an adrenal vein sampling is necessary for exact localization. Spironolactone, an aldosterone antagonist, is the drug of choice for patients with an aldosterone-producing adenoma or hyperplasia. It can control elevated blood pressure in most primary aldosteronism patients. However, unilateral laparoscopic adrenalectomy is the best treatment for aldosterone-producing adenoma or asymmetrical aldosterone production in patients with uncontrolled hypertension. Here we report a patient with primary aldosteronism caused by unilateral adrenal hyperplasia and a contralateral adrenal adenoma who required as many as five different kinds of antihypertensive medications for controlling elevated blood pressure. The adrenal adenoma was successfully removed by unilateral adrenalectomy and the blood pressure had been controlled well after the surgery.

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References

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