Abstract
An 11 yr old white male with severe hypertension (150-170/100-120), hypokalemia (2.6-2.9 mEq/L) and suppressed plasma renin (PRA)(<20 ng/dl/hr) was studied. Initial random serum and urine aldosterone (Aldo) were 19 ug/dl and 11 ng/dl. Antihypertensive therapy and potassium supplementation were begun. Results of dexamethasone (Dex) suppression, ACTH stimulation and adrenal vein sampling are indicated in Table. B, corticosterone; DOC, Deoxycorticosterone; F, Cortisol.
The partial suppression of Aldo by Dex and stimulation by ACTH suggested hyperplasia; however, the paradoxical decline in Aldo with upright posture suggested a tumor. Adrenal venography indicated an enlarged left adrenal not confirmed by computed tomography. Because spironolactone failed to correct hypertension, a left adrenalectomy was performed which revealed macronodular hyperplasia. After surgery, hypertension improved along with normalization of biochemical and hormonal abnormalities. Adrenal vein sampling was the most useful test in determining the etiology of hyperaldosteronism.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Costin, G., Grushkin, C. UNILATERAL MACRONODULAR ADRENAL HYPERPLASIA: A RARE CAUSE OF PRIMARY HYPERALDOSTERONISM. Pediatr Res 21 (Suppl 4), 246 (1987). https://doi.org/10.1203/00006450-198704010-00472
Issue Date:
DOI: https://doi.org/10.1203/00006450-198704010-00472