Abstract
Background A 27-year-old woman presented to her primary-care physician with severe hypertension after complaining of fatigue over the preceding months. She was otherwise asymptomatic. She was referred to a hypertension clinic and was found to be hypokalemic. She was immediately commenced on amlodipine, with atenolol added 2 weeks later. After 4 weeks of this drug therapy, her hypertension persisted and investigations to exclude secondary causes of hypertension were performed.
Investigations Aldosterone and renin levels were measured under controlled conditions and the results expressed as an aldosterone-to-renin ratio. CT of the adrenal glands was also performed.
Diagnosis Adenomatous primary aldosteronism (Conn's syndrome).
Management The patient was initially treated with spironolactone before undergoing a laparoscopic left adrenalectomy.
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Acknowledgements
JMCC is supported by a Medical Research Council (MRC) program grant. EMF is a Clinical Research Fellow funded by the Wellcome Trust.
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Freel, E., Connell, J. Diagnosis of adenomatous primary aldosteronism in a patient with severe hypertension. Nat Rev Endocrinol 1, 111–115 (2005). https://doi.org/10.1038/ncpendmet0047
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DOI: https://doi.org/10.1038/ncpendmet0047
