A case of primary aldosteronism due to unilateral adrenal hyperplasia

Yasuyuki Katayama, Nobuki Takata, Taiji Tamura, Akemi Yamamoto, Fumihiko Hirata, Hiroko Yasuda, Susumu Matsukuma, Yuichiro Daido, Hironobu Sasano

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19 Citations (Scopus)

Abstract

The case of a patient with primary aldosteronism due to unilateral adrenal hyperplasia (UAH) is reported. A 43-year-old man with an 8-year history of hypertension presented at our institution with hypokalemia, increased plasma aldosterone concentration (PAC), and suppressed plasma renin activity (PRA). An abdominal CT scan showed almost normal adrenal glands with slight enlargement in the left gland. 131I-Norcholesterol adrenal scintigraphy under dexamethasone suppression showed bilaterally decreased uptake. To rule out idiopathic hyperaldosteronism, an adrenal vein sampling before and after ACTH stimulation was performed and a left-sided lateralization of PAC was observed. A left adrenalectomy was performed, and the patient had a good clinical and biochemical response. Micronodular hyperplasia was discovered in the adrenal gland histologically, and in the immunohistochemical analysis, positive staining for 3β-hydroxysteroid dehydrogenase in micronodular lesions confirmed the diagnosis of UAH. Although UAH is a rare subset of primary aldosteronism, it is surgically correctable as a unilateral autonomous aldosterone-producing lesion. Careful investigations, including bilateral adrenal vein sampling, should be performed for the diagnosis.

Original languageEnglish
Pages (from-to)379-384
Number of pages6
JournalHypertension Research
Volume28
Issue number4
DOIs
Publication statusPublished - 2005 Apr 1

Keywords

  • Adrenal vein sampling
  • Hyperaldosteronism
  • Secondary hypertension
  • Unilateral adrenal hyperplasia

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Katayama, Y., Takata, N., Tamura, T., Yamamoto, A., Hirata, F., Yasuda, H., Matsukuma, S., Daido, Y., & Sasano, H. (2005). A case of primary aldosteronism due to unilateral adrenal hyperplasia. Hypertension Research, 28(4), 379-384. https://doi.org/10.1291/hypres.28.379