Introduction Spironolactone is a specific competitive antagonist of aldosterone, the most potent endogenous mineralocorticoid, which modifies renal electrolyte handling and is therefore commonly used as a diuretic in conditions associated with secondary hyperaldosteronism. In renal insufficiency, aldosterone antagonists may induce significant hyperkalaemia even if administered concurrently with...

Adrenal masses that are found incidentally should be evaluated with both imaging and hormonal studies. The attenuation coefficient on noncontrast computed tomography (CT), expressed in Hounsfield units (HU), is better than tumor size in differentiating adrenal adenomas and hyperplastic lesions from nonadenomas. All patients should undergo hormonal evaluation for Cushing syndrome and pheochromoc...

Glucocorticoid-remediable aldosteronism is a hereditary form of primary hyperaldosteronism and the most common monogenic cause of hypertension. We present the case of a 24-year-old man with a family history of Conn's syndrome. Yet, in the index patient, classical characteristics of mineralocorticoid excess could be reversed by exogenous glucocorticoids.

90 Maedica A Journal of Clinical Medicine, Volume 7 No.1 2012 Update in Endocrinology – Primary Hyperaldosteronism – From Secondary Hypertension Towards Metabolic Syndrome and Beyond Raluca-Alexandra TRIFANESCU, MD, PhDa,b; Catalina POIANA, MD, PhDa,b aEndocrinology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania b“C.I.Parhon” National Institute of Endocrinolo...

PrimaryAaldosteronism (PA) is a group of endocrine disorders in which aldosterone production is inappropriately high, autonomous of the renin-angiotensin system and not suppressed by sodium loading1. Bilateral idiopathic hyperaldosteronism (IHA) and aldosterone producing adenoma (APA) are the most common subtypes of PA. It is estimated that more than 10% of patients with secondary hypertension ...

Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension. Apart from hypertension, hypokalaemia was hitherto considered to be the classical cardinal symptom. Its presence was therefore also usually a prerequisite for further diagnostic clarification in respect of PH. However, numerous new studies in normokalaemic hypertension patients now show that serum potassium leve...

Hyperaldosteronism has been demonstrated to be associated with magnesium loss in the urine and hypomagnesemia1 as part of the syndrome of metabolic alkalosis and hypokalemia that characterizes this condition. In this issue of Circulation, Chhokar et al2 demonstrate the consequences of metabolic changes in rats subjected to aldosterone infusion in the presence of excess salt that result in hypoc...

Dexamethasone-suppressible hyperaldosteronism is a rare familial syndrome in which hypokalemia, suppression of plasma renin concentration, and elevated aldosterone secretion are corrected by treatment with glucocorticoids. Regulation of adrenocortical function and body electrolytes was studied in two affected brothers. Both were hypertensive (210/128 and 160/106 mm Hg) with hypokalemia (3.3 and...

Atrial fibrillation (AF) involves 1% to 2% of the adult general population, a rate that increases to 15% in those 80 years and above. Because of the aging of the general population, this epidemic of AF is expected to increase over the next decades and to impose an increasing burden on the healthcare system because of the need for life-long care and pharmacological treatment. Identification of t...