Hyperaldosteronism is a disorder in which the adrenal gland releases too much of the hormone aldosterone into the blood. Hyperaldosteronism can be primary or secondary.
9. Aldosteronism caused by
autonomous production of
aldosterone by the adrenal
cortex (due to hyperplasia,
adenoma, or carcinoma)
Increased adrenal
production of aldosterone
in response to nonpituitary,
extra-adrenal stimuli such
as renal hypoperfusion
A syndrome featuring
hypokalemia, metabolic
alkalosis, and suppressed
renin in the absence of
elevated aldosterone levels
18. Practice…
A 35-year-old man is evaluated for poor exercise tolerance and muscle weakness.
He has no past medical history. His blood pressure is 175-185 mmHg systolic and
105-115 mmHg diastolic on repeat measurements. His pulse is 78-95/min. Laboratory
results are as follows:
Sodium 146 mEq/L
Potassium 2.4 mEq/L
Glucose 95 mg/dL
Creatinine 0.7 mg/dL
What is your next step????
19. Answer: CT Scan
CT scan of the abdomen
reveals a 3-cm mass in the
left adrenal gland.
What is your
diagnosis???
21. Which of the following additional findings
would be expected in this patient? ? ?
Plasma Renin Activity Serum Aldosterone Serum Bicarbonate
A High High Low
B High High High
C Low High High
D Low High Low
E High Low High
22. What is the next step???
Answer:
Adrenalectomy
23.
24. In Summary
• Diagnosis should be suspected in hypertensive patients with hypokalemia.
• Initial testing includes measurement of plasma aldosterone levels and
plasma renin activity.
• Adrenal imaging tests are done, but often bilateral adrenal vein
catheterization is needed to distinguish tumor from hyperplasia.
• Tumors are removed and patients with adrenal hyperplasia are treated with
aldosterone blockers such as spironolactone or eplerenone.
25. References
• Agabegi, S. (2019). Step-up to medicine (5th ed.). Baltimore, MD: Wolters Kluwer Health.
• Penman, I. D., Ralston, S. H., Strachan, M. W. J., & Hobson, R. (Eds.). (2022). Davidson’s
principles and practice of medicine (24th ed.). London, England: Elsevier Health Sciences.
• G. (n.d.). Primary Aldosteronism - Endocrine and Metabolic Disorders - MSD Manual
Professional Edition. MSD Manual Professional Edition.
https://www.msdmanuals.com/professional/endocrine-and-metabolic-disorders/adrenal-
disorders/primary-aldosteronism