The invisible evil twin of an adrenal adenoma / Aimi Fadilah M … [et al.]

Mohamad, Aimi Fadilah and Mohamed Shah, Fatimah Zaherah and Zainordin, Nur Aisyah and Eddy Warman, ur 'Aini and Ab Mumin, Nazimah and Omar, Effat and Abdul Ghani, Rohana (2019) The invisible evil twin of an adrenal adenoma / Aimi Fadilah M … [et al.]. Journal of Clinical and Health Sciences, 4 (1). pp. 1-6. ISSN 0127-984X


Primary aldosteronism (PA) causes a persistently elevated blood pressure (BP) due to excessive release of the hormone aldosterone from the adrenal glands. Classically, it is called Conn’s syndrome and is described as the triad of hypertension and hypokalemia with the presence of unilateral adrenal adenoma. It can be cured with surgical resection of the aldosterone-secreting adenoma leading to resolution of hypertension, hypokalemia and increased cardiovascular risk associated with hyperaldosteronism. We present a case of a man with previous ischemic heart disease (IHD) who presented with resistant hypertension. Investigations for secondary causes of hypertension revealed an elevated aldosterone level and saline suppression test confirmed the diagnosis of PA. Radiological examination revealed a left adrenal adenoma and a normal right adrenal gland. However, adrenal venous sampling showed lateralization of aldosterone secretion towards the right. He subsequently underwent a laparoscopic right adrenalectomy which improved his BP control promptly. This case highlights the importance of recognizing the need to investigate for secondary causes of hypertension. It also underscores the importance of dynamic tests, which may not be easily accessible to most clinicians but should pursue, to allow a definitive diagnosis and effective treatment.


Item Type: Article
CreatorsEmail / ID. Num
Mohamad, Aimi
Mohamed Shah, Fatimah ZaherahUNSPECIFIED
Zainordin, Nur AisyahUNSPECIFIED
Eddy Warman, ur 'AiniUNSPECIFIED
Ab Mumin, NazimahUNSPECIFIED
Abdul Ghani, RohanaUNSPECIFIED
Subjects: Q Science > QP Physiology
Q Science > QP Physiology > Cerebral cortex
Q Science > QP Physiology > Cerebral cortex > Auditory cortex. Sensorimotor cortex
Divisions: Universiti Teknologi MARA, Selangor > Puncak Alam Campus > Faculty of Medicine
Journal or Publication Title: Journal of Clinical and Health Sciences
Journal: UiTM Journal > Journal of Clinical and Health Sciences (JCHS)
ISSN: 0127-984X
Volume: 4
Number: 1
Page Range: pp. 1-6
Official URL:
Item ID: 30048
Uncontrolled Keywords: primary aldosteronism, hypertension, adrenal adenoma, adrenal vein sampling


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