Primary aldosteronism: Difference between revisions
From IDWiki
m (Aidan moved page Primary hyperaldosteronism to Primary aldosteronism) |
No edit summary |
||
| Line 1: | Line 1: | ||
| + | == Clinical Manifestations == |
||
| + | |||
| + | * Usually asymptomatic except for hypertension and hypokalemia |
||
| + | * Can have muscle cramps |
||
| + | * Family history |
||
| + | * Resistant hypertension |
||
| + | * Adrenal incidentaloma |
||
| + | * Early onset hypertension |
||
| + | * High normal sodium |
||
| + | * Metabolic alkalosis |
||
== Differential Diagnosis == |
== Differential Diagnosis == |
||
| − | * Bilateral adrenal hyperplasia (60%) |
+ | * Bilateral [[adrenal hyperplasia]] (60%) |
| − | * Adrenal adenoma, which causes [Conn syndrome] |
+ | * [[Adrenal adenoma]], which causes [[Conn syndrome]] |
| − | * Adrenal carcinoma (rare) |
+ | * [[Adrenal carcinoma]] (rare) |
| − | * Familial hyperaldosteronism |
+ | * [[Familial hyperaldosteronism]] |
| + | |||
| + | == Diagnosis == |
||
| + | |||
| + | * Screening with plasma aldosterone/plasma renin ratio |
||
| + | ** Done preferably in morning sample |
||
| + | ** Taken in a sitting position after at least 15 minutes of rest |
||
| + | ** Avoid aldosterone antagonists, ARBs, β-blockers |
||
| + | * Diagnosed with: |
||
| + | ** Oral salt load |
||
| + | ** Saline suppression |
||
| + | ** Captopril |
||
| + | |||
| + | == Management == |
||
| + | |||
| + | * Surgery if unilateral |
||
| + | * [[Spironolactone]] if bilateral |
||
[[Category:Endocrinology]] |
[[Category:Endocrinology]] |
||
Latest revision as of 13:50, 15 October 2021
Clinical Manifestations
- Usually asymptomatic except for hypertension and hypokalemia
- Can have muscle cramps
- Family history
- Resistant hypertension
- Adrenal incidentaloma
- Early onset hypertension
- High normal sodium
- Metabolic alkalosis
Differential Diagnosis
- Bilateral adrenal hyperplasia (60%)
- Adrenal adenoma, which causes Conn syndrome
- Adrenal carcinoma (rare)
- Familial hyperaldosteronism
Diagnosis
- Screening with plasma aldosterone/plasma renin ratio
- Done preferably in morning sample
- Taken in a sitting position after at least 15 minutes of rest
- Avoid aldosterone antagonists, ARBs, β-blockers
- Diagnosed with:
- Oral salt load
- Saline suppression
- Captopril
Management
- Surgery if unilateral
- Spironolactone if bilateral
