Abstract
Primary hyperaldosteronism is not as uncommon as we thought, and by recent estimates the prevalance may be as high as 11% among hypertensives. We present a case of a 33 years old male patient came with a complaint of headache in occipital area & weakness in both lower limb since 4 weeks. The patient was a diagnosed case of hypertension and was already on tablet Atenolol (25 mg) once a day. At the time of admission, the patient was found to have a pulse of 96/min and blood pressure of 170/100 mm of Hg. Power was 3/5 for both right and left lower limbs. At the time of admission, serum potassium was 2.8. As a result, the patient was shifted to tablet Metroprolol and Amlodipine (50 + 5 mg) once a day. We also added tablet Cilnidipine (10 mg) and Telmisartan (80 mg) once a day and syrup Potklor thrice a day with water. The patient was sent for renal artery doppler, urine for metanephrines and vanillylmandelic acid, serum aldosterone, plasma aldosterone/plasma renin activity ratio (PAC/PRA ratio), urinary aldosterone, urinary cortisol and adrenocorticotrophic hormone level and computed tomography (CT) abdomen to rule out hyperaldostronism. Plasma aldosterone/plasma renin activity ratio, urinary aldosterone was high and CT abdomen revealed a solitary nodule in the left adrenal gland measuring 1.2 × 1.0 cm in maximum transverse diameter, which was suggestive of adrenal adenoma. Diagnosis of Conn’s syndrome secondary to adrenal adenoma was made. The patient was advised tablet Aldactone (25 mg) once a day and serum electrolytes were repeated which showed normalization with normal blood pressure.
Highlights
Primary hyperaldosteronism is more commonly recognized than in the past
The patient was sent for renal artery doppler, urine for metanephrines and vanillylmandelic acid, serum aldosterone, plasma aldosterone/plasma renin activity ratio (PAC/PRA ratio), urinary aldosterone, urinary cortisol and adrenocorticotrophic hormone level and computed tomography (CT) abdomen to rule out hyperaldostronism
Plasma aldosterone/plasma renin activity ratio, urinary aldosterone was high and CT abdomen revealed a solitary nodule in the left adrenal gland measuring 1.2 × 1.0 cm in maximum transverse diameter, which was suggestive of adrenal adenoma
Summary
Primary hyperaldosteronism is more commonly recognized than in the past In older series, it was found in only 0.1% to 0.5% of hypertensive patients [1]. Y. Fulara 48 mains unclear, this is almost certainly an underestimate. Primary aldosteronism is still a considerable diagnostic challenge, recognizing the condition is critical because primary aldosteronism-associated hypertension can often be cured (or at least optimally controlled) with the proper surgical or medical intervention. In this case report, we present a patient who presented with very nonspecific symptoms and was later diagnosed with Conn’s syndrome
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