Hyperaldosteronism Signs and Symptoms

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

• 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

• 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

• 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 are nonspecific
  • Symptoms caused by hypertension (eg headache), hypokalemia (eg polyuria, nocturia, muscle cramps and weakness, tetany, paralysis, etc), and metabolic alkalosis