Open AccessHypertension with unilateral adrenal aldosterone and cortisol cosecreting adenoma: A case report
Author(s) -
Hu Zhe,
Chen Xin,
Shao Yuan,
Luo FangXiu,
Chu ShaoLi,
Wang JiGuang
Publication year - 2021
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.14374
Subject(s) - medicine , primary aldosteronism , aldosterone , adrenal adenoma , endocrinology , plasma renin activity , adenoma , hypokalemia , hydrocortisone , adrenalectomy , hyperaldosteronism , subclinical infection , blood pressure , renin–angiotensin system
Here, we report a case of unilateral adrenal aldosterone and cortisol co‐secreting adenoma. A 34‐year‐old man with a history of severe hypertension for one year was detected hypokalemia (2.42 mmol/L lowest) and unilateral adrenal mass in a size of 71 mm*63 mm. Measurements of plasma aldosterone concentration and plasma renin activity showed marked increases. Primary aldosteronism was diagnosed. To exclude adrenal malignancy, the function of zona fasciculate was evaluated, and 24‐h urine free cortisol was found abnormal in a testing. Further examinations revealed that circadian rhythm of serum cortisol disappeared and 2 mg‐dexamethasone suppression test was positive. The final diagnosis was secondary hypertension, primary aldosteronism and subclinical Cushing's syndrome. After unilateral adrenalectomy, his blood pressure was normalized and biochemical parameters in the normal range. In conclusion, in patients with a large aldosterone‐producing adenoma, the function of zona fasciculate might have to be evaluated for the identification of aldosterone and cortisol co‐secreting neoplasms.