Open AccessA case of liddle′s syndrome; unusual presentation with hypertensive encephalopathy
Author(s) -
Sunil Kumar Kota,
Siva Krishna Kota,
Sagar Suman Panda,
Kirtikumar D Modi
Publication year - 2014
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.135185
Subject(s) - medicine , spironolactone , hypertensive encephalopathy , hyperaldosteronism , amiloride , hypokalemia , blood pressure , metabolic alkalosis , plasma renin activity , aldosterone , endocrinology , bartter's syndrome , secondary hypertension , gastroenterology , renin–angiotensin system , sodium , chemistry , organic chemistry
Liddle's syndrome is a rare cause of secondary hypertension. Identification of this disorder is important because treatment differs from other forms of hypertension. We report an interesting case of a 35-year-old lady, a known diabetic and hypertensive patient, who presented with features of hypertensive encephalopathy. The family history was unremarkable. Past treatment with various combinations of antihypertensive medications including spironolactone, all at high doses, failed to control her blood pressure. Upon evaluation, the patient had hypokalemic alkalosis, low 24-h urine potassium and suppressed plasma renin activity. Although these findings were similar to hyperaldosteronism, plasma aldosterone was lower than the normal range. Blood pressure decreased markedly after administration of amiloride. Along with hyporeninemic hypo-aldosteronism, the non-responsiveness to spironolactone and good response to amiloride established the diagnosis of Liddle's syndrome.