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.
Patients with bilateral adrenal hyperplasia or those unsuitable for surgery is recommended to be treated medically by mineralocorticoid receptor antagonists
They appear to be effective in blood pressure control and protection for blood pressure-independent target organ
First-line agent for the medical treatment of hyperaldosteronism
Mineralocorticoid receptor antagonist that acts on the distal portion of the renal tubule as a competitive antagonist of aldosterone and it also increases sodium and water excretion and reduces potassium excretion
An androgen receptor antagonist and progesterone agonist
Dose-related gynecomastia was observed
A small dose of thiazide diuretic, Triamterine, or Amiloride may be given to avoid the side effects of high dose Spironolactone
Alternative to Spironolactone
Selective mineralocorticoid antagonist that has no anti-androgen and progesterone agonist effects
It should be given twice daily due to its shorter half-life
An epithelial sodium channel antagonist that can ameliorate blood pressure and hypokalemia
Less efficacious than Spironolactone but may be useful
It has no sex steroid-related side effects but no beneficial effects on endothelial function
Angiotensin-converting enzyme (ACE) inhibitor
Can be added if hypertension persists
For patients with angiotensin II sensitive adenoma or hyperplasia
Efficacy in the low plasma renin state may in part reflect the role of even low concentrations of angiotensin II as an aldosterone secretagogue in adrenal hyperplasia
Individuals with obstructive sleep apnoea (OSA) may have an increased risk of COVID-19, with the risk reducing with adherence to positive airway pressure (PAP) therapy, according to a study presented at ATS 2021.
Year 6 and 7 cumulative data from the Mirena Extension Trial suggest that the efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) as a contraceptive method is maintained over this time frame.
In a webinar held on 27 March 2021, paediatric
endocrinology nurses Karen Blair,
Kate Davies, and Siti Zarina Yaakop shared
insights and clinical experience based
on their frontline roles in caring for patients
with central precocious puberty (CPP)
and supporting their family members.