Endocrine Abstracts

Introduction: Hyperaldosteronism usually presents with hypertension and hypokalemia; however, there is recent evidence of a relationship with the parathyroid hormone. There are different theories to try to explain this relationship. Hyperaldosteronism treatment is medical or surgical depending upon etiology. We present three cases in which treatment solely for hyperaldosteronism also cured hyperparathyroidism.

Materials and methods: We report three patients in whom hyperaldosteronism was diagnosed during 2015 and detected simultaneously hyperparathyroidism. We recorded epidemiological data, pre- and post-surgical phospho-calcium metabolism, as well as hyperaldosteronism.

Results: Case 1: A 38 year old male was referred for suspected hyperaldosteronism. A nodule was detected in left adrenal in TC image. Levels of PTH 150 pg/ml were objectified with normal serum and urinary calcium and phosphorus. Levels of vitamin D were 19.9 ng/ml. After left adrenalectomy, PTH levels were normalized. Case 2: A 55 years old woman referred for study of hypokalemia. Her PTH levels were 162 pg/ml with normal serum phosphorus and urinary calcium. Lesion 20 mm in left adrenal was detected in TC image. After adrenalectomy, PTH levels down to 34 pg/ml. Case 3: A 63 years old woman was referred to rule out hyperaldosteronism. She presented PTH levels of 136 pg/ml and normal levels of serum calcium and phosphorus. Vitamin D levels were 24 ng/ml. MRI image showed right adrenal injury that was removed. After surgery, PTH levels diminished.

Conclusions: In cases of primary hyperaldosteronism is advisable to assess the phospho-calcium metabolism, especially PTH. The effect of hyperaldosteronism on bone long-term is still unknown. In any case, the calcium/phosphorus levels were not pathological. Sometimes treatment solely of hyperaldosteronism can simultaneously treat hyperparathyroidism.