A patient with concurrent primary aldosteronism and Page kidney
Journal
Endocrine
Journal Volume
38
Journal Issue
1
Pages
6-10
Date Issued
2010
Author(s)
Abstract
The ratio of aldosterone-to-renin activity is currently recommended as a screening test for primary aldosteronism (PA). There are many factors interfering the interpretation of aldosterone-renin ratio (ARR) and could hamper in-time diagnosis of PA. Here, we first report a patient with underlying Page phenomenon and an accidentally disclosed adrenal incidentaloma. High renin secretion from Page phenomenon had masked higher ARR into normal ARR obscuring the diagnosis of PA. However, adrenal venous sampling (AVS) confirmed the autonomous aldosterone secretion with left adrenal vein plasma aldosterone concentration (PAC) 124.1 ng/dl and a lateralization ratio 3.3. AVS may discriminate masked PA due to high renin secretion from Page kidney. It is suggested that clinicians should cautiously interpret aldosterone-renin ratio and consider diagnostic AVS if hyperaldosteronism is highly suspected especially in the background of other secondary hypertension. ? 2010 Springer Science+Business Media, LLC.
Other Subjects
aldosterone; alpha adrenergic receptor blocking agent; calcium channel blocking agent; captopril; dipeptidyl carboxypeptidase inhibitor; nifedipine; renin; spironolactone; adrenal incidentaloma; adult; aldosterone release; article; blood pressure regulation; case report; clinical feature; comorbidity; computer assisted tomography; differential diagnosis; flank pain; heart left ventricle hypertrophy; hematoma; human; hypertension; incidental finding; kidney cyst; kidney disease; male; primary hyperaldosteronism; priority journal; radioimmunoassay; renin angiotensin aldosterone system; renin release; thorax radiography; treatment response
Type
journal article