A 41-year-old man with a 10-year history of hypertension presents to clinic for routine follow-up. On examination, blood pressure is 158/96 mmHg. Laboratory studies show serum potassium 3.1 mEq/L, serum sodium 144 mEq/L, and serum creatinine 0.9 mg/dL. Plasma renin activity is suppressed at 0.1 ng/mL/hr (normal: 0.6-1.6). Plasma aldosterone is 28 ng/dL (normal: 3-16). A non-contrast CT of the abdomen reveals a 1.3-cm left adrenal nodule with homogeneous enhancement and no lipid content. After intravenous saline loading (500 mL/hr for 4 hours), aldosterone concentration decreases only to 24 ng/dL. Which of the following is the most likely diagnosis?
- A)Idiopathic hyperaldosteronism
- B)Glucocorticoid-remediable aldosteronism
- C)Secondary hyperaldosteronism from renal artery stenosis
- D)Primary hyperaldosteronism due to bilateral adrenal hyperplasia
- E)Aldosterone-producing adenomaGABARITO
Explicação
This patient has primary hyperaldosteronism (Conn syndrome) with classic findings: hypertension, hypokalemia, suppressed plasma renin activity, and elevated plasma aldosterone. The combination of a unilateral adrenal adenoma (1.3 cm) on imaging with minimal su... Ver explicação completa e trilha adaptativa →