Hyperaldosteronism

28/07/2013 by admin | Endocrine
  1. This is treatment resistant HTN (2% of HTN), with hypokalaemia. Occasionally potassium is normal if sodium intake is low.
    1. o Benign adenoma (=Conn’s syndrome = [an aldosterone producing adenoma of the adrenal gland] – 66% of hyperaldosteronism)
    2. o Bilateral adrenal hyperplasia (30%)
    3. o Rarely glucocorticoid remedial aldosteronism or adrenal carcinoma
  2. Ix:
    1. o Lab: hypokalaemia, increased urinary potassium, supressed renin and elevated aldosterone
    2. o Imaging: CT of adrenals, radio-labelled cholesterol scan and adrenal vein sampling
  3. Tx:
    1. o Surgery = adrenalectomy for Conn’s adenoma
    2. o Aldosterone antagonists (spironolactone/amiloride) for other causes 
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