Premium
METABOLIC AND HORMONAL STUDIES IN A PATIENT WITH PRIMARY ALDOSTERONISM, PRESENTING WITH ACUTE HYPOKALÆMIC PARESIS INDUCED BY CHLOROTHIAZIDE
Author(s) -
STOKES G. S.,
GENTLE JANICE L.,
EDWARDS K. D. G.,
SCOGGINS B. A.,
COGHLAN J. P.
Publication year - 1968
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1968.17.2.148
Subject(s) - chlorothiazide , primary aldosteronism , plasma renin activity , endocrinology , aldosterone , medicine , spironolactone , hyperaldosteronism , hypoaldosteronism , liter , renin–angiotensin system , blood pressure , diuretic
Summary Primary aldosteronism was discovered in a woman aged 27 years known to have been hypertensive for four years, and who presented with severe muscular weakness of acute onset after one week's treatment with chlorothiazide. Metabolic studies were carried out at three levels of sodium intake—“ normal ”(84 mEq per day), “ high ”(200 mEq per day) and “ low ”(16 mEq per day)—and also during treatment with desoxycorticosterone acetafe or spironolactone. Sodium loading caused a significant fall in the serum potassium concentration from 4·6 to 3·4 mEq/l., and a significant increase in the urinary potassium excretion from 165 mEq per day to 215 mEq per day. The plasma renin activity was abnormally low, being suppressed under all conditions of testing to a level below the lower limit of sensitivity of the assay used. The plasma aldosterone concentration was consistently high (mean 45, range 18 to 64 mµg. per 100 ml). Removal of an aldosterone‐producing tumour resulted in correction of the abnormal plasma levels of aldosterone and renin, and relief of hypertension and hypokalæmia.