In the primary or hyporeninemic
hyperaldosteronism, autonomous hypersecretion of aldosterone is held by neoplastic tissue, adrenocortical adenomas or adenocarcinomas, or by nodular hyperplasia of the zona glomerulosa of the adrenal cortex, also known as primary
hyperaldosteronism or non neoplastic
hyperaldosteronism.
In primary
hyperaldosteronism with elevated aldosterone levels, there is a corresponding decrease in plasma renin activity demonstrating renin-aldosterone dissociation (Javadi et al.
Characterization of NCI-H295R cells as an in vitro model of
hyperaldosteronism," Hormone and Metabolic Research, vol.
Hereditary forms of primary aldosteronism typically manifest more florid symptoms, with the exception of familial
hyperaldosteronism type II, which is clinically and biochemically indistinguishable from sporadic cases.
From this, Pratt-Ubunama concluded that
hyperaldosteronism may induce and/or exacerbate OSA.
A case of myelolipoma with bilateral adrenal
hyperaldosteronism cured after unilateral adrenalectomy.
Primary
hyperaldosteronism was ruled out by low plasma renin and aldosterone levels.
1) Other inherited metabolic disorders that may be associated with monogenic hypertension during childhood and adolescence include apparent mineralocorticoid excess, glucocorticoid remediable aldosteronism, familial
hyperaldosteronism type 2, Liddle's syndrome, Gordon's syndrome, activating mutations of the mineralocorticoid receptor, and generalized glucocorticoid resistance.
Venous sampling is used to localise the source of adrenal hormonal secretion, especially in the evaluation of
hyperaldosteronism.
Hyperfunctioning syndromes include hypercortisolism,
hyperaldosteronism, adrenogenital hypersecretion of adrenocortical origin, and pheochromocytomas of the medulla.
A case of insulin edema with inappropriate
hyperaldosteronism.
Causes of metabolic alkalosis Chloride-responsive Chloride-resistant (U-[Cl-] <5 (U-[Cl-] >40 mmol/l) mmol/l) Gastric fluid losses
Hyperaldosteronism (vomiting, nasogastric suction) Apparent mineralocorticoid excess Diuretics (late) syndromes Posthypercapnia Cushing's syndrome Cystic fibrosis Liddle's syndrome Congenital chloride Bartter or Gitelman diarrhoea syndrome Villous adenoma Diuretics (early) Excess bicarbonate administration Table compiled from references 1 and 4.
