Spontaneous hypokalaemia in a man with treated hypertension

[...]aldosterone production comes under the control of adrenocorticotrophin. There is excess secretion of aldosterone, as well as 18-hydroxycortisol and 18-oxocortisol-both of which can be measured in the urine. Because glucocorticoids can suppress the secretion of adrenocorticotrophin, aldosterone...

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Bibliographic Details
Published in:BMJ (Online) 2015-04, Vol.350 (apr30 2), p.h2154-h2154
Main Authors: Ahmed, S H, Ewins, David L, Nair, Sunil, Joseph, Franklin
Format: Article
Language:English
Subjects:
Adrenal Gland Neoplasms - complications
Adrenal Gland Neoplasms - diagnosis
Adrenal glands
Adrenocortical Adenoma - complications
Adrenocortical Adenoma - diagnosis
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Biopsy
CASE REVIEW
Diagnosis, Differential
Drug dosages
Humans
Hypertension
Hypertension - drug therapy
Hypertension - etiology
Hypokalemia - blood
Hypokalemia - etiology
Laparoscopy
Male
Medical prognosis
Mortality
Potassium
Surgery
Tomography
Tomography, X-Ray Computed
Tumors
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Summary:[...]aldosterone production comes under the control of adrenocorticotrophin. There is excess secretion of aldosterone, as well as 18-hydroxycortisol and 18-oxocortisol-both of which can be measured in the urine. Because glucocorticoids can suppress the secretion of adrenocorticotrophin, aldosterone synthesis becomes uniquely responsive to steroids, which are used to treat this condition. A mineralocorticoid receptor antagonist may be needed to control blood pressure. 3 Unlike type I familial hyperaldosteronism, type II and type III don't respond to glucocorticoid therapy. Because their clinical course is resembles that of sporadic primary hyperaldosteronism, management is similar.
ISSN:0959-8138
1756-1833
1756-1833
DOI:10.1136/bmj.h2154