Endocrine Abstracts

Introduction: We should consider testing for primary aldosteronism in the presence of hypertension and hypokalaemia, resistant hypertension, onset of hypertension at a young age (<20 year), severe hypertension and whenever considering secondary hypertension.

Case report: We presented the case of a 38 years old woman who was admitted in the National Institute of Endocrinology C.I. Parhon Bucharest for the evaluation of high blood pressure. She has high blood pressure for 10 years (maximum value 190/100 mm/Hg) and she is on β blocker and angiotensin II receptor blockers. She has no other medical history and her blood pressure is still 150/80 mm/Hg on the antihypertensive drugs. She has heredocolateral antecedents of high blood pressure (her mother). After she has stopped for 4 weeks the antihypertensive drugs, we detected hypopotasemia (K: 2.9 nmol/l), normal serum natrium, and normal biochemia but high levels of serum aldosterone (121 ng/ml) and low levels of serum renin (2 μUI/ml) with plasma metanephrines and normetanephrines in the upper normal range and normal plasma cortisol with good response after 1 mg overnight dexamethasone suppression test. An adrenal computed tomography has been performed and we discovered a left adrenal mass of 1.2/0.9 cm. We have replaced the β blocker with Spironolactona (200 mg per day) and Aspacardin and on these medications she has high normal blood pressure and normal potassemia. The patient was transferred to the surgery where they performed laparoscopic adrenalectomy. 2 weeks after surgery she has normal blood pressure and normal natraemia and potassemia without medications.

conclusion: We presented the case of woman with primary hyperaldosteronism and although she has high blood pressure for 10 years and we have not expected that it would be entiraly coreccted after surgery, patient did not need any antihypertensive drugs after surgery.