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CASE REPORT
Primary hyperaldosteronism: a case of unilateral adrenal hyperplasia with contralateral incidentaloma
  1. Sujit Vakkalanka1,
  2. Andrew Zhao1,
  3. Mohammed Samannodi2
  1. 1University at Buffalo, Buffalo, New York, USA
  2. 2Department of Medicine, Buffalo, New York, USA
  1. Correspondence to Dr Mohammed Samannodi, samannodi{at}gmail.com

Summary

Primary hyperaldosteronism is one of the most common causes of secondary hypertension but clear differentiation between its various subtypes can be a clinical challenge. We report the case of a 37-year-old African-American woman with refractory hypertension who was admitted to our hospital for palpitations, shortness of breath and headache. Her laboratory results showed hypokalaemia and an elevated aldosterone/renin ratio. An abdominal CT scan showed a nodule in the left adrenal gland but adrenal venous sampling showed elevated aldosterone/renin ratio from the right adrenal vein. The patient began a new medical regimen but declined any surgical options. We recommend clinicians to maintain a high level of suspicion to consider the less common subtypes of primary hyperaldosteronism, especially given the fact that the management greatly varies.

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