Unilateral primary aldosteronism with spontaneous remission after long-term spironolactone therapy

The Journal of Clinical Endocrinology and Metabolism
Takashi YonedaYoshiyu Takeda

Abstract

Medical treatment with a mineralocorticoid receptor (MR) antagonist, which has produced spontaneous remission of bilateral primary aldosteronism (PA), may also produce spontaneous remission of unilateral PA, for which laparoscopic adrenalectomy is recommended. However, few reports exist regarding spontaneous remission after MR antagonist therapy in unilateral PA. The aim of this paper is to report a case of unilateral PA with spontaneous remission and reduction of cardiac hypertrophy after long-term spironolactone (SP) therapy. A 41-yr-old Japanese male was treated for hypertension and hypokalemia for 5 yr. Primary aldosteronism was diagnosed by a furosemide and upright posture test and a captopril challenge test. Computed tomography imaging showed a 5-mm left-sided adrenal mass. Adrenal vein sampling demonstrated overproduction of aldosterone from the left adrenal gland. Long-term treatment with SP normalized the plasma aldosterone concentration. After discontinuation of SP, the patient's blood pressure, serum potassium level, and plasma aldosterone concentration remained in the normal range. The associated cardiac hypertrophy also improved and continued to resolve even after discontinuation of SP. Although the left adrenal gl...Continue Reading

Citations

Oct 1, 2013·Endocrine Journal·Yoshihiro MiyakeToshihiko Yanase
Jul 28, 2015·Pharmacology & Therapeutics·Jaap DeinumJacques W M Lenders
Mar 15, 2015·European Journal of Endocrinology·Kyeong Seon ParkSeong Yeon Kim
Oct 16, 2014·European Journal of Endocrinology·Laurence AmarPierre-Francois Plouin
Jun 19, 2016·Annales d'endocrinologie·Antoinette Pechère-BertschiHervé Lefebvre
Oct 21, 2016·The Journal of Clinical Hypertension·Decio ArmaniniLuciana Bordin
Mar 12, 2019·Current Pharmaceutical Design·Konstantinos StavropoulosMichael Doumas
Aug 16, 2012·The Journal of Clinical Endocrinology and Metabolism·Evelyn FischerMartin Reincke
Jul 21, 2017·Clinical and Experimental Hypertension : CHE·Shigehiro KarashimaTakashi Yoneda
Nov 1, 2012·Expert Review of Endocrinology & Metabolism·Tetsuo NishikawaYoko Matsuzawa
Apr 2, 2021·Internal Medicine·Mitsuhiro KometaniYoshiyu Takeda
May 1, 2021·International Journal of Molecular Sciences·Yoshimichi TakedaYoshiyu Takeda

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