A 17-year-old boy is referred for severe hypertension (BP 168/102 mmHg, HR 88, RR 16, temp 37°C) discovered during a sports physical. Laboratory studies reveal hypokalemia (K+ 2.8 mEq/L), metabolic alkalosis (HCO3− 32 mEq/L), and suppressed plasma renin activity with low aldosterone levels. Urine sodium is elevated at 180 mEq/day. He denies licorice use and takes no medications. Which of the following is the most likely cause?
- A)Constitutive activation of epithelial sodium channels in principal cellsGABARITO
- B)Excess aldosterone secretion from an adrenal adenoma
- C)Hyposecretion of aldosterone due to diabetic nephropathy
- D)Defective Na K 2Cl cotransporter in the thick ascending limb
- E)Reduced responsiveness to antidiuretic hormone
Explicação
Liddle syndrome is caused by gain of function of ENaC in the collecting tubule, which leads to sodium retention, hypertension, hypokalemia, and metabolic alkalosis. Because the sodium retention is primary, renin and aldosterone are both suppressed. Ver explicação completa e trilha adaptativa →