This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Oberfield, S. E. Articles by New, M. I. Search for Related Content PubMed PubMed Citation Articles by Oberfield, S. E. Articles by New, M. I.

Hypertension, Vol 6, 75-84, Copyright © 1984 by American Heart Association

ARTICLES

Primary hyperaldosteronism in childhood due to unilateral macronodular hyperplasia. Case report

SE Oberfield, LS Levine, A Firpo, Sr Lawrence D, E Stoner, DJ Levy, S Sen and MI New

We present the first report of primary hyperaldosteronism in childhood due to unilateral macronodular hyperplasia. A 10-year-old white boy with severe hypertension (150/100 mm Hg), hypokalemia (1.4 mEq/liter), and suppressed plasma renin activity (PRA) (less than 0.1 ng/ml/hr) demonstrated fixed PRA and aldosterone (aldo) levels that did not change with alteration of dietary sodium. The paradoxical decrease in serum aldo on assumption of upright posture suggested a tumor. Prolonged ACTH administration produced a continuous rise in blood pressure, but a transient rise in aldo. A minimal decrease in urinary aldo during dexamethasone administration was noted, excluding dexamethasone-suppressible hyperaldosteronism. Blood pressure normalized with spironolactone. Computerized transaxial tomography, iodocholesterol scanning, and adrenal venography were not diagnostic of a discrete adrenal lesion. Although hyperplasia is more common than an adenoma as a cause of hyperaldosteronism in childhood, a tumor was predicted, since adrenal vein hormone sampling with ACTH stimulation lateralized aldosterone secretion unequivocally to the left adrenal gland. However, left adrenalectomy revealed macronodular hyperplasia. Postoperatively, there was reversal of hypertension, hypokalemia, and hyperaldosteronism. Thus, in childhood, unilateral hypersecretion of aldosterone may result from nodular hyperplasia, rather than a discrete adenoma.

This article has been cited by other articles:

				A. Rabinstein, S. Falcone, A. Forteza, and A. Forteza Diffusion-weighted Imaging Shows Cytotoxic and Vasogenic Edema in Eclampsia AJNR Am. J. Neuroradiol., June 1, 2001; 22(6): 1068 - 1070. [Abstract] [Full Text] [PDF]