hyperaldosteronism
HYPERALDOSTERONISM
Hyperaldosteronism is a group of disorders in which aldosterone production is inappropriately high, relatively autonomous & non-suppressible by sodium loading.
Signs & symptoms are nonspecific.
Symptoms are caused by hypertension (eg headache), hypokalemia (eg polyuria, nocturia, muscle cramps & weakness, tetany, paralysis, etc) & metabolic alkalosis.

Definition

  • Hyperaldosteronism is a group of disorders in which aldosterone production is inappropriately high, relatively autonomous and non-suppressible by sodium loading

Etiology

  • Hyperplasia eg idiopathic (bilateral) hyperplasia, primary (unilateral) adrenal hyperplasia
  • Familial Hyperaldosteronism II
    • Non-glucocorticoid remediable; maybe associated with familial occurrence of aldosterone-producing adenoma, idiopathic hyperaldosteronism, or both
Glucocorticoid-Remediable Aldosteronism (Familial Hyperaldosteronism I)
  • Monogenetic disorder related to hypertension
  • Adrenocortical hyperplasia is present which may be nodular
    • Histological features suggest over activity of the zona fasciculata
    • Progression to tumor has not been reported
  • Patients are usually asymptomatic young hypertensives
  • Diagnosis may be made with suppression of plasma aldosterone with Dexamethasone or southern blotting of genetic defect
  • Treat with low-dose Dexamethasone
Apparent Mineralocorticoid Excess
  • Rare congenital condition
  • Spironolactone may be used to control electrolyte imbalance
  • Blood pressure (BP) control usually needs other antihypertensive agents
    • Eg Angiotensin-converting enzyme (ACE) inhibitors, thiazide diuretics
  • Low-dose Dexamethasone may be useful

Liddle’s Syndrome

  • Rare congenital condition
  • Treat with Spironolactone but may also require Amiloride or Triamterene

Signs and Symptoms

  • Signs and symptoms are nonspecific
    • Symptoms caused by hypertension (eg headache), hypokalemia (eg polyuria, nocturia, muscle cramps and weakness, tetany, paralysis, etc), and metabolic alkalosis
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
01 Jun 2015
New drug applications approved by US FDA as of 15 – 31 May 2015 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.