Primary hyperaldosteronism associated to an adrenal neoplasia. Case report
DOI:
https://doi.org/10.20453/rmh.v33i4.4407Keywords:
Hypokalemia, nephrolithiasis, aldosteroneAbstract
We report the case of a 68-year-old male with a history of non-treated arterial hypertension diagnosed the previous year that was admitted with anasarca, muscle weakness and dyspnea at rest. The first laboratory exams showed severe hypopotassemia, metabolic alkalosis, renal and gallbladder lithiasis and chronic renal disease. The abdominal tomography revealed a right suprarenal tumor, bilateral hydronephrosis and renal and gallbladder lithiasis. Under the suspicion of primary hyperaldosteronism, the diagnosis was confirmed with the determination of the relationship between aldosterone/direct renin concentration, which was high. The metabolic study showed hypercalciuria and hyperuricosuria and the potassium trans tubular gradient was above 7. The patient underwent right nephrectomy, nonetheless, died at the immediate post-operatory period due to a hypovolemic shock and respiratory failure.
Downloads
References
Simpson SA, Tait JF, Bush IE. Secretion of a salt-retaining hormone by the mammalian adrenal cortex. Lancet. 1952;2(6727):226-8.
Arnold DT, Reed JB, Burt K. Evaluation and Management of the Incidental Adrenal Mass. Bayl Univ Med Cent. 2003;16(1):7-12.
Ng L, Libertino JM. Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol. 2003;169(1):5-11.
Vaidya A, Carey RM. Evolution of the Primary Aldosteronism Syndrome: Updating the Approach. J Clin Endocrinol Metab. 2020;105(12):3771.
Hiperaldosteronismo primario | Nefrología al día [Internet]. [Citado el 12 de octubre 2021]; Disponible en: https://www.nefrologiaaldia.org/es-articulo-hiperaldosteronismo-primario-406
Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol. 2006;48(11):2293-300.
Seccia TM, Fassina A, Nussdorfer GG, Pessina AC, Rossi GP. Aldosterone-producing adrenocortical carcinoma: an unusual cause of Conn’s syndrome with an ominous clinical course. Endocr Relat Cancer. 2005;12(1):149-59.
Ganguly A. Primary Aldosteronism. N Engl J Med. 1998;339(25):1828-34.
Nakamura Y, Yamazaki Y, Felizola SJ, Ise K, Morimoto R, Satoh F, et al. Adrenocortical carcinoma: review of the pathologic features, production of adrenal steroids, and molecular pathogenesis. Endocrinol Metab Clin North Am. 2015;44(2):399-410.
Williams TA, Gomez-Sanchez CE, Rainey WE, Giordano TJ, Lam AK, Marker A, et al. International Histopathology Consensus for Unilateral Primary Aldosteronism. J Clin Endocrinol Metab. 2021;106(1):42-54.
Yamazaki Y, Nakamura Y, Omata K, Ise K, Tezuka Y, Ono Y, et al. Histopathological Classification of Cross-Sectional Image–Negative Hyperaldosteronism. J Clin Endocrinol Metab. 2017;102(4):1182-92.
Ahmed AA, Thomas AJ, Ganeshan DM, Blair KJ, Lall C, Lee JT, et al. Adrenal cortical carcinoma: pathology, genomics, prognosis, imaging features, and mimics with impact on management. Abdom Radiol (NY). 2020;45(4):945-63.
Ohno Y, Sone M, Inagaki N, Yamasaki T, Ogawa O, Takeda Y, et al. Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism: A Multicenter Study in Japan. Hypertension. 2018;71(3):530-7.
Breslau NA. Pathogenesis and management of hypercalciuric nephrolithiasis. Miner Electrolyte Metab. 1994;20(6):328-39.
Khanna A, Kurtzman NA. Metabolic alkalosis. J Nephrol. 2006;19 Suppl 9: S86-96.
Shey J, Cameron MA, Sakhaee K, Moe OW. Recurrent calcium nephrolithiasis associated with primary aldosteronism. Am J Kidney Dis. 2004;44(1): e7-12.
Malysz J, Petkov GV. Urinary bladder smooth muscle ion channels: expression, function, and regulation in health and disease. Am J Physiol Renal Physiol. 2020;319(2): F257-83.
Schwartz BF, Stoller ML. The vesical calculus. Urol Clin North Am. 2000;27(2):333-46.
Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016;175(2): G1-34.
Hundemer GL, Vaidya A. Management of endocrine disease: The role of surgical adrenalectomy in primary aldosteronism. Eur J Endocrinol. 2020;183(6): R185-96. Recibido: 10/06/2022Aceptado: 11/08/2022
Downloads
Published
How to Cite
Issue
Section
License
Authors assign their rights to the RMH so that may disseminate the article through the means at their disposal. The journal will provide forms of affidavit of authorship and authorization for the publication of the article, which shall be submitted with the manuscript. Authors retain the right to share, copy, distribute, perform and publicly communicate their article, or part of it, mentioning the original publication in the journal.
