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Primary aldosteronism is the syndrome resulting from the secretion of excessive amounts of aldosterone. It is clinically characterized by a combination of hypertension, hypokalemia, increased plasma aldosterone, and suppressed plasma renin ( 1 ). The wide availability of the sensitive aldosterone assay and of adrenal imaging techniques have made it mucheasier to make the diagnosis. Although the incidence has been reported to be less than 0.5% of all hypertensive patients, it is now one of the most representative causes of surgically curable endocrine hypertension. Therefore, there is no question about the importance of making correct diagnosis. The underlying adrenal disease is usually a unilateral solitary adenoma (APA) and could be cured by unilateral adrenalectomy. However, bilateral adrenal hyperplasia referred as idiopathic hyperaldosteronism (IHA) is seen in about one-

Variant Forms of Primary Aldosteronism: Reconsideration of the Differential Diagnosis and Treatment