Primary Hyperparathyroidism: Possible Cause of Primary Hyperaldosteronism in a 60-Year-Old Woman*

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Abstract
Hypertension and hypokalemia were found in a 60 yr old women suffering from primary hyperparathyroidism. Laboratory investigations in this patient disclosed elevated levels of plasma aldosterone (PA) which could not be suppressed by a high Na diet alone or in combination with fludrocortisone (Florinef); a decline of the elevated PA levels after 4 h of ambulation and low PRA [plasma renin activity] which was unresponsive to stimulation by a low Na diet coupled with diuretic-induced volume depletion and 4 h of ambulation. These findings were consistent with the diagnosis of primary hyperaldosteronism. Extirpation of a parathyroid adenoma reduced the patient''s serum Ca level to normal, and subsequently, a normalization of her blood pressure, serum electrolytes, PA and PRA were observed. In this case hyperaldosteronism may have been caused directly or indirectly by primary hyperparathyroidism.

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