Endocrine Abstracts

Introduction: Hyperaldosteronism is not so common in middle-aged groups. But it should be concerned in the case of unclear hypertension, fatigue, or dyspepsia.

A 61-year-old female was hospitalized in the private clinic ‘Oberig’ in December 2019. She had non-specific complaints such as weakness, dyspepsia, constipation, vomiting, losing an appetite, decrease in body weight. She has been treated for a long time out-patiently and had some episodes of hospitalization, including the surgical unit. She had severe electrolyte disorders, such as hyponatremia (106 mmol/l), hypokalemia (1.8 mmol/l), hypochloremia (62.8 mmol/l), hypophosphatemia (0.54). Magnesium was normal (97 mmol/l). AKSH and cortisol were in the normal range. She has arterial hypertension since being 25–30 years old. She was reported to have multinodular goiter for four years. She received levothyroxine 50 mg daily, but we detected that TSH was slightly less than average (0.36). There was a decision to decrease the dosage to 25 mg with further TSH control in 1 month. After normalization of the potassium level in the blood, we checked aldosterone and renin. Aldosterone was normal, renin was less than average, and their correlation was increased up to 37 (normal range is lower than 18.7). Adrenal hyperplasia was not detected on CT. We prescribed eplerenone 50 mg. Soon in 1 month, all symptoms regressed, and the patient felt much better.

Conclusion: Electrolyte screening is essential for diagnostic unclear dyspepsia and hypertension.