Diagnostic features of normotensive primary aldosteronism and literature review

doi:10.3877/cma.j.issn.2095-655X.2019.04.008

Abstract

Abstract:

Objective

To explore the diagnostic features of normotensive primary aldosteronism (PA).

Methods

The clinical data of a normotensive PA patient admitted to the Department of Endocrinology of the Third Affiliated Hospital of Sun Yat-sen University on May 4, 2018 were analyzed retrospectively and literatures were reviewed.

Results

A 39-year-old female patient was hospitalized because of 3-year limb weakness and numbness, and 2-day deterioration. The patient presented normotension, hypokalemia (2.10 mmol/L), high aldosterone level (465.83 pmol/L) and low rennin level (2.90 ng/L). CT scan displayed a right adrenal cortical adenoma (23 mm×18 mm). The patient was diagnosed with PA eventually. Interestingly, the blood pressure was normal during the whole period.

Conclusion

Normotensive PA should be considered when a patient presents hypokalemia paralysis without hypertension.

Key words: Hyperaldosteronism, Aldosterone, Normotension, Hypokalemia

Bilian Zhu, Ben Liu, Panwei Mu. Diagnostic features of normotensive primary aldosteronism and literature review[J]. Chinese Journal of Diagnostics(Electronic Edition), 2019, 07(04): 254-258.

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Figures/Tables 5

References 16

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项目	血清钾(mmol/L)	血清钠(mmol/L)	血清氯(mmol/L)	尿钾(mmol/24 h)	尿钠(mmol/24 h)	尿氯(mmol/24 h)	尿量(ml/24 h)
第3天	1.82	148	98.40	42.00	158.70	133.40	2 300
第4天	1.93	148	100.20	57.40	171.00	139.50	3 000
第5天	2.18	147	100.10	83.80	237.60	201.00	3 300

项目	血清钾(mmol/L)	血清钠(mmol/L)	血清氯(mmol/L)	尿钾(mmol/24 h)	尿钠(mmol/24 h)	尿氯(mmol/24 h)	尿量(ml/24 h)
第3天	1.82	148	98.40	42.00	158.70	133.40	2 300
第4天	1.93	148	100.20	57.40	171.00	139.50	3 000
第5天	2.18	147	100.10	83.80	237.60	201.00	3 300

项目	肾素浓度(ng/L)	血管紧张素Ⅱ(ng/L)	醛固酮(pmol/L)	醛固酮/肾素[(pmol/L)/(ng/L)]
8∶00 am (卧床)	2.90	94.93	465.83	160.63
12∶00 pm(站立4 h后)	5.54	65.98	536.23	96.79
参考值	4～24(卧)	25～129(卧)	27.70～443.20(卧)	?
?	4～38(立)	49～252(立)	110.80～858.70(立)	?

项目	肾素浓度(ng/L)	血管紧张素Ⅱ(ng/L)	醛固酮(pmol/L)	醛固酮/肾素[(pmol/L)/(ng/L)]
8∶00 am (卧床)	2.90	94.93	465.83	160.63
12∶00 pm(站立4 h后)	5.54	65.98	536.23	96.79
参考值	4～24(卧)	25～129(卧)	27.70～443.20(卧)	?
?	4～38(立)	49～252(立)	110.80～858.70(立)	?

项目	血钾(mmol/L)	血钠(mmol/L)	血氯(mmol/L)	皮质醇(nmol/L)	ACTH(pmol/L)	肾素浓度(ng/L)	血管紧张素Ⅱ(ng/L)	醛固酮(pmol/L)	醛固酮/肾素[(pmol/L)/(ng/L)]
8∶00 am	2.24	147	99.40	345.31	8.26	2.75	51.09	462.83	168.30
10∶00 am	2.31	147	99.00	184.00	5.13	2.91	23.55	462.07	158.79

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