ALDOSTERONE-SECRETING ADENOMA: REPORT OF A CASE IN A JUVENILE

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Abstract
A case study of a 16 year old Caucasian female who was found to have hypertension at 13 years of age. She was relatively asymptomatic except for nocturia and an occasional headache. The blood pressure was about 160/100 mm. Hg. The serum K ranged from 2.8 to 3.5 meq/I; the serum Na ranged from 146 to 160 meq/1; and the CO2 combining power, from 23 to 31 meq/1. The only evidence of a metabolic alkalosis was the slight increase in the CO2 content which was 56.9 vol. % (normal 45-55). The salivary Na:K ratio ranged from 0.25 to 0.43 (normal> 1.0). The Nae was 49.6 meq/kg (normal 35.1-41.6). Ke was 35.2 meq/kg (normal 38.5-54.4). Uropepsin excretion rate was 60 units per hour (normal 15-40). Thermal sweat Na was 14 meq/l (normal> 47). Urinary aldosterone excretion rate was 70 and 80 [mu]g/24 hours (normal 8-12). The administration of 60 units of adrenocorticotrophin (ACTH) gel twice daily resulted in a moderate retention of Na and K for the first 2 days followed by a mild diuresis of Na on the 3d and 4th day of ACTH. The 17-keto-steroids and 17-hydroxysteroids on control days were normal and showed a normal response to ACTH stimulation. After the removal of an adrenal cortical adenoma, the patient recovered subjectively and objectively and the laboratory findings returned to normal. Primary aldosteronism should be considered in every patient with hypertension.