Primary Aldosteronism with Suppressed Plasma Renin Activity Due to Bilateral Nodular Adrenocortical Hyperplasia
Authors: FRED H. KATZ
Journal: Annals of Internal Medicine (1967)

Case Studies1 November 1967Primary Aldosteronism with Suppressed Plasma Renin Activity Due to Bilateral Nodular Adrenocortical HyperplasiaFRED H. KATZ, M.D.FRED H. KATZ, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-5-1035 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPrimary aldosteronism is diagnosed with confidence if overproduction of aldosterone is associated with suppressed plasma renin activity (1). The anatomical finding of adrenocortical adenomas in such patients has been emphasized (2). Before the recognition of the importance of plasma renin determinations in making this diagnosis numerous cases of primary aldosteronism with bilateral adrenocortical hyperplasia rather than tumors were reported (3-5), although most patients had one or more adenomas. In the cases with hyperplasia, however, the diagnosis must now be questioned because the aldosteronism could be secondary to the overproduction of renin due to various causes (6).This report describes a...References1. CONNCOHENROVNER JWELDR: Suppression of plasma renin activity in primary aldosteronism: distinguishing primary from secondary aldosteronism in hypertensive disease. JAMA 190: 213, 1964. CrossrefMedlineGoogle Scholar2. CONNROVNERCOHENNESBIT JWDRELRM: Normokalemic primary aldosteronism: its masquerade as "essential" hypertension. JAMA 195: 21, 1966. CrossrefGoogle Scholar3. CHOBANIANBURROWSHOLLANDER AVBAW: Body fluid and electrolyte composition in arterial hypertension. II. Studies in mineralocorticoid hypertension. J. Clin. Invest. 40: 416, 1961. CrossrefMedlineGoogle Scholar4. CONN JW: Aldosteronism and hypertension. Primary aldosteronism versus hypertensive disease with secondary aldosteronism. Arch. Intern. Med. (Chicago) 107: 813, 1961. CrossrefMedlineGoogle Scholar5. GILBERTBELLBARTTER JWNHFC: Primary aldosteronism: diagnosis and surgical treatment. Ann. Surg. 158: 195, 1963. CrossrefMedlineGoogle Scholar6. COHENROVNERCONN ELDRJW: Postural augmentation of plasma renin activity: importance in diagnosis of renovascular hypertension. JAMA 197: 973, 1966. CrossrefMedlineGoogle Scholar7. DAVISKLIMANYANKOUPOULOSPETERSON JOBNARE: Increased aldosterone secretion following acute constriction of the inferior vena cava. J. Clin. Invest. 37: 1783, 1958. CrossrefMedlineGoogle Scholar8. KATZ FH: Adrenal function during bed rest. Aerospace Med. 35: 849, 1964. MedlineGoogle Scholar9. PETERSON RE: The miscible pool and turnover rate of adrenocortical steroids in man. Recent Progr. Hormone Res. 15: 231, 1959. Google Scholar10. ULICKLARAGHLIEBERMAN SJHS: Isolation of a urinary metabolite of aldosterone and its use to measure the rate of secretion of aldosterone by the adrenal cortex of man. Trans. Ass. Amer. Physicians 71: 225, 1958. MedlineGoogle Scholar11. BUSH IE: Methods of paper chromatography of steroids applicable to the study of steroids in mammalian blood and tissues. Biochem. J. 50: 370, 1952. CrossrefMedlineGoogle Scholar12. EBERLEINBONGIOVANNI WRAM: New solvent systems for the resolution of corticosteroids by paper chromatography. Arch. Biochem. 59: 90, 1955. CrossrefMedlineGoogle Scholar13. PETERSONKARRERGUERRA REASL: Evaluation of Silber-Porter procedure for determination of plasma hydrocortisone. Anal. Chem. 29: 144, 1957. CrossrefGoogle Scholar14. WILSONREISMANMOYER BDDCA: Fluid balance in the urological patient: disturbances in the regulation of the excretion of water and sodium salts following decompression of the urinary bladder. J. Urol. 66: 805, 1951. CrossrefMedlineGoogle Scholar15. SYMINGTONJEFFRIES TR: The pathology of adrenocortical lesions causing hyperadrenalism, in The Human Adrenal Cortex, edited by CURRIE, A. R., SYMINGTON, T., GRANT, J. K. E. & S. Livingstone, Ltd., Edinburgh, 1962, p. 345. Google Scholar16. KAPLAN NM: The incidence of primary aldosteronism in patients with "essential" hypertension (abstract). J. Lab. Clin. Med. 66: 883, 1965. Google Scholar17. SUTHERLANDRUSELAIDLAW DJJLJC: Hypertension, increased aldosterone secretion and low plasma renin activity relieved by dexamethasone. Canad. Med. Ass. J. 95: 1109, 1966. MedlineGoogle Scholar18. NEWPETERSON MIRE: A new form of congenital adrenal hyperplasia. J. Clin. Endocr. 27: 300, 1967. CrossrefMedlineGoogle Scholar19. RAITIKOWARSKIMORRISMIGEON SARECJ: Some aspects of the control of aldosterone secretion in man. Bull. Hopkins Hosp. 119: 407, 1966. Google Scholar20. GANONGBIGLIERIMULROW WFEGPJ: Mechanisms regulating adrenocortical secretion of aldosterone and glucocorticoids. Recent Progr. Hormone Res. 22: 381, 1966. MedlineGoogle Scholar21. MEANSDEGROOTSTANBURY JHLJJB: The Thyroid and Its Diseases, 3rd ed. McGraw-Hill Book Co., Inc., New York, 1963, p. 475. Google Scholar22. MCINTOSHPETERSONMCPHAUL DAEWJJ: Autonomy of parathyroid function after renal homotransplantation. Ann. Intern. Med. 65: 900, 1966. LinkGoogle Scholar23. MOSIERFLYNNWILLTURNER HDPJDWRD: Cushing's syndrome with multinodular adrenal glands. J. Clin. Endocr. 20: 632, 1960. CrossrefGoogle Scholar24. BARTTERBIGLIERI FCEG: Primary aldosteronism: clinical staff conference at the National Institutes of Health. Ann. Intern. Med. 48: 647, 1958. LinkGoogle Scholar25. REMENCHIKMILLERTALSOWILLOUGHBY APCPJEO: Depletion of body potassium by diuretics. Circulation 33: 796, 1966. CrossrefMedlineGoogle Scholar26. NEVILLESYMINGTON AMT: Pathology of primary aldosteronism. Cancer 19: 1854, 1966. CrossrefMedlineGoogle Scholar27. DAVISNEWSOMEWRIGHTHAMMONDEASTONBARTTER WWHHLDWGJFC: Bilateral adrenal hyperplasia as a cause of primary aldosteronism with hypertension, hypokalemia and suppressed renin activity. Amer. J. Med. 42: 642, 1967. CrossrefMedlineGoogle Scholar28. LARAGHLEDINGHAMSOMMERS JHJGSC: Secondary aldosteronism and reduced plasma renin in hypertensive disease. Trans. Ass. Amer. Physicians 80: in press, 1967. MedlineGoogle Scholar29. SLATONSCHAMBELANBIGLIERI PEMEG: A test for the diagnosis of aldosterone producing adenoma (abstract). Program of the Forty-Ninth Meeting of the Endocrine Society, Miami Beach, Fla., June 15, 1967. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago and Hines, IllinoisFrom the Departments of Medicine, University of Chicago, Argonne Cancer Research Hospital, Chicago, and Loyola University Stritch School of Medicine, Hines, Ill.This study was supported in part by contracts AF 41 (609)-2786 and F 41609-67-C0008, U. S. Air Force, Washington, D. C.Requests for reprints should be addressed to Fred H. Katz, M.D., Department of Medicine, Loyola University Stritch School of Medicine, Hines, Ill. 60141. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Impact of Glucocorticoid Co-Secretion in Primary Aldosteronism on Thyroid Autoantibody Titers During the Course of DiseaseCellular and Genetic Causes of Idiopathic HyperaldosteronismAutoimmune Mechanisms Activating the Angiotensin AT1 Receptor in 'Primary' AldosteronismAdrenal venous sampling analysis of primary aldosteronism: value of ACTH stimulation in the differentiation of adenoma and hyperplasiaPrimary AldosteronismMay a lymphocytic infiltration have a pathogenic role in an aldosterone-producing adrenal tumor?USE OF AN INTRAVENOUS SODIUM LOAD IN SCREENING FOR PRIMARY HYPERALDOSTERONISMClinical disorders of aldosterone metabolismEndokrine Aspekte des HochdrucksSyndromes of Aldosterone Deficiency and ExcessPrimary Aldosteronism: Pathophysiology, Diagnosis and TreatmentSurgery of primary aldosteronismEndocrine Aspects of Hypertension2 Primary hyperaldosteronismUse of Computed Tomography in Diagnosing the Cause of Primary AldosteronismEndokrine Aspekte des HochdrucksAdrenocortical diseasesThe treatment of low-renin ("primary") hyperaldosteronismClinical, biochemical and pathological features of low-renin ("primary") hyperaldosteronismPlasma and urinary aldosterone and their interrelations with blood pressure, plasma renin activity and urinary electrolytes in normotensive subjectsNew mineralocorticoids and adrenocorticosteroids in hypertensionADRENAL STEROIDOGENESIS IN "LOW RENIN" OR HYPORENINEMIC HYPERTENSIONPrimary aldosteronismAdrenal steroidogenesis in "low renin" or hyporeninemic hypertensionControl of plasma aldosterone in a patient with Conn's Syndrome before and during spironolactone medicationAldosteronexkretion und Plasmareninaktivit�t von Patienten mit essentieller Hypertonie und mit reninsupprimiertem HyperaldosteronismusSyndrome of Benign Nodular Adrenal Hyperplasia Associated with Feminization and HyperprolactinemiaR. M. BOYAR, M.D., LEON HELLMAN, M.D., F.A.C.P.EPISODIC SECRETION OF ALDOSTERONE IN PRIMARY ALDOSTERONISM: RELATIONSHIP TO CORTISOLThe use of spironolactone in the diagnosis and the treatment of hypertension associated with mineralocorticoid excessThe regulation of aldosterone secretion in primary aldosteronismThe structure of the human adrenal cortex in health and diseaseAdrenal mineralocorticoids causing hypertensionThe generation and maintenance of metabolic alkalosisPhotoscanning of Tumors in Primary Aldosteronism: Possible Distinction from "Idiopathic" AldosteronismPseudo-Primary Aldosteronism, a Variant of Low Renin, Essential Hypertension?MineralocorticoidsyndromeDetermination of Plasma Renin Concentration by Angiotensin I ImmunoassayHypermineralocorticoidismus und HypertonieREFERENCESThe Relationship between Angiotensin and AldosteroneHypertension, Adrenal Abnormalities, and Alterations in Plasma Renin ActivityJ. CAULlE GUNNELLS JR., M.D., F.A.C.P., W. L. MCGUFFIN JR., M.D., R. R. ROBINSON, M.D., F.A.C.P., C. E. GRIM, M.D., SAMUEL WELLS, M.D., DONALD SILVER, M.D., J. F. GLENN, M.D.The Control of Aldosterone Secretion and Its Relationship to the Diagnosis of HyperaldosteronismHochdruck und Aldosteronismus bei solitären Adenomen und bei nodulärer Hyperplasie der NebennierenrindeALDOSTERONISM AND SPIRONOLACTONEJAMES G. HILTON, M.D.Primary Aldosteronism: Diagnosis and TreatmentLaboratory Aids in the Diagnosis of Endocrine DisordersAldosteronism in Hypertension The Spironolactone Response TestRICHARD F. SPARK, M.D., JAMES C. MELBY, M.D. 1 November 1967Volume 67, Issue 5Page: 1035-1042KeywordsAdenomasAdrenalectomyAldosteroneBlood plasmaHospital medicinePlasma renin activityPotassiumResearch laboratoriesSurgery Issue Published: 1 November 1967 PDF downloadLoading ...