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A Case of Primary Aldosteronism Diagnosed by Repeated Hormonal Investigations Mitsunori Ohtsubo 1 , Hideyuki Takano 1 , Hiroto Sakai 1 , Hisashi Kon 1 , Chikara Adachi 2 , Tatsuo Kaneda 3 , Takayoshi Demura 3 , Takaya Hioka 3 , Hiroko Gotoda 4 1Division of Cardiology, Hokkaido Chuo Rosai Hospital 2Division of Internal Medicine, Tsukigata Municipal Hospital 3Division of Urology, Sapporo Kosei Hospital 4Division of Pathology, Sapporo Kosei Hospital Keyword: 原発性アルドステロン症 , 血漿レニン活性 , 副腎静脈サンプリング , primary aldosteronism , plasma renin activity , adrenal venous sampling pp.221-224
Published Date 2009/2/15
DOI https://doi.org/10.11477/mf.1404101212
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 A 35-year-old hypertensive and hypokalemic male patient, who demonstrated normorenin values on the first hormonal check, was referred to our institute. Because hypokalemia persisted and he was rather young to have another form of essential hypertension, we suspected secondary hypertension and repeated the hormonal check. A later examination demonstrated suppressed renin and increased aldosterone. Furthermore, the captopril-loading test result suggested PA. However, none of the imaging modalities detected abnormal adrenal structure. Adrenal venous sampling showed significant excessive aldosterone secretion from the left adrenal gland. Therefore, the patient was diagnosed as having PA. Laparoscopic adrenalectomy was performed, and histopathological examination found cortical adenoma. Our case suggested that even if a patient demonstrates normal plasma renin activity and plasma aldosterone concentration, the possibility of PA cannot be entirely excluded. Some patients with PA may be overlooked, especially when hormonal data appear normal on first examination. Repeat hormonal investigations should be considered in cases of hypertension.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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