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Hyperaldosteronism

 Syn. Primary aldosteronism

Signs & Symptoms

 Thiazide drug treatment
Note: Trigger
Ref: Harrison [ 2729]
Spontaneous diuresis
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]
Persistent hypervolemia
Note: cause increase in systemic vascular resistance
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]
Resistant hypertension
Note: to three drugs including a diuretic
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]

Physical Examination

 Hypertension
Note: Major clinical finding
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism] Harrison [ 2729] Cecil [ 650]
Positive Chvostek sign
Note: due to metabolic alkalosis
Ref: Cecil [ 650]
Positive Trousseau sign
Note: due to metabolic alkalosis
Ref: Cecil [ 650]

Lab / Serology

 Very Low PRC
Ref: Uptodate [ Diagnosis of primary aldosteronism] Harrison [ 2729]
Hypokalemia
Note: Patients with idiopathic hyperplasia (IHA)
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism] Harrison [ 2729] Cecil [ 650]
Progressive hypokalemia
Note: some other factor is added, such as increased aldosterone production or the use of diuretic therapy
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]

Imagin Study

 Adrenal incidentaloma
Ref: Uptodate [ Diagnosis of primary aldosteronism]
Decreased left ventricular function
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]
Greater left ventricular mass
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]

Complication

 Cognitive dysfunction
Ref: Harrison [ 2729]
Connshing syndrome
Ref: Harrison [ 2729]
Osteoporosis
Ref: Harrison [ 2729]

Risk Factors

 Young
Ref: Uptodate [ Diagnosis of primary aldosteronism]
Female
Ref: Cecil [ 650]

Cause

 Bilateral idiopathic hyperaldosteronism
Note: Usually micronodular
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism] Harrison [ 2728] Cecil [ 649]
Somatic mutations adenomas
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism] Harrison [ 2728]
Familial hyperaldosteronism
Ref: Uptodate [ Pathophysiology and clinical features of primary aldosteronism]

Other