A case of primary aldosteronism due to bilateral adrenal hyperplasia associated with non-functioning adrenal tumor.

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A case of primary aldosteronism due to bilateral adrenal hyperplasia associated with non-functioning adrenal tumor is reported. A 41-year-old man was admitted to our hospital because of the evaluation of hypertension and hypokalemia. Hypertension was diagnosed 1 year before and he had been followed at a practitioner's outpatient clinic with nifedipine. Hypokalemia was found and he was referred to us for further evaluation. On admission, hypertension, hypokalemia were noted, plasma renin activity (PRA) was low and plasma aldosterone was high. PRA was not stimulated by intravenous furosemide administration and 2-hour standing. Diurnal variation of aldosterone was disappeared, while diurnal variation of cortisol was present. A small right adrenal tumor was found on computerized tomography. Radio-iodinated adosterol was accumulated to bilateral adrenal gland equally on adrenal scintigram. Plasma aldosterone in both right and left adrenal veins were high by selective adrenal vein sampling. Based on these data, diagnosis of primary aldosteronism due to bilateral adrenal hyperplasia and non-functional adrenal tumor was made. Hypertension and hypokalemia were successfully treated with spironolactone.
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