1/5. Primary aldosteronism caused by aldosterone-producing adenoma in pregnancy--complicated by EPH gestosis.pregnancy in conjunction with primary aldosteronism is an unusual occurrence. We report a 28-year-old woman who presented with mild hypertension and hypokalemia as manifestations of primary aldosteronism caused by an aldosterone-producing adenoma in the left adrenal gland during pregnancy. Although the diagnosis was straightforward, the patient refused to undergo the proposed operation during the second trimester of her pregnancy. She was not admitted to hospital until she developed EPH gestosis in the 27th week of gestation, which had an unfavourable outcome for the infant who died nine days after delivery. The patient underwent a laparoscopic adrenalectomy which resulted in normalization of blood pressure and blood potassium levels. In cases of aldosterone-producing adenoma, surgery in the second trimester is the most appropriate option to avoid a poor obstetric outcome.- - - - - - - - - - ranking = 1keywords = aldosteronism (Clic here for more details about this article) |
2/5. Selective hypoaldosteronism due to combined defects of the conversion from inactive renin to active renin and the aldosterone biosynthesis from corticosterone.A 24-year-old Japanese woman with IgA nephropathy exhibited a decreased serum aldosterone level with normal plasma renin activity after toxemia of pregnancy. Our studies revealed selective hypoaldosteronism with normal adrenoglucocorticoid functions. Levels of serum corticosterone and deoxycorticosterone were normal. Resting plasma renin activity was normal, and plasma levels of total and inactive renin were increased. Rapid ACTH administration failed to stimulate any secretion of aldosterone, whereas it adequately increased serum cortisol, deoxycorticosterone, and corticosterone concentrations. Responses of both plasma renin activity and serum aldosterone level to the furosemide-posture challenge were blunted. angiotensin ii also failed to stimulate any secretion of aldosterone despite a progressive rise in blood pressure and an appropriate increase in serum corticosterone. These results suggest that combined defects of the conversion from inactive renin to active renin and aldosterone biosynthesis are the causes of selective hypoaldosteronism in our patient.- - - - - - - - - - ranking = 1keywords = aldosteronism (Clic here for more details about this article) |
3/5. diagnosis and management of primary aldosteronism in pregnancy: case report and review of the literature.Primary aldosteronism rarely complicates pregnancy. We present a woman with primary aldosteronism in pregnancy associated with severe preeclampsia. A 33-year-old Japanese woman with hypertension was referred to our hospital at 25 weeks of gestation. Her blood pressure was 180/100 mmHg, and laboratory tests identified a low serum potassium level and moderate proteinuria on urinalysis. The fetus was diagnosed with growth restriction. plasma renin activity (PRA) value was 2.2 ng/mL/h and plasma aldosterone concentration (PAC) was elevated (260 pg/mL). The patient was treated medically. At 27 weeks of gestation, we noted persistent late fetal heart rate decelerations associated with uterine contractions. Therefore, elective caesarean section was performed and she was delivered of a 698-g female. After delivery, PRA declined and PAC remained elevated. Abdominal computerized tomography scan and I131-iodochoresterol scan revealed a tumor in the left adrenal gland. Laparoscopic adrenalectomy was performed and confirmed the clinical diagnosis.- - - - - - - - - - ranking = 1keywords = aldosteronism (Clic here for more details about this article) |
4/5. Lobular pattern of choriocapillaris in pre-eclampsia with aldosteronism.We report a case of geographic or mosaic pattern yellowish opaque foci in the left eye of a 36-year-old woman who suffered from severe pre-eclampsia. Though the geographic lesions resulted in chorioretinal atrophy, the mosaic lesion led to no significant atrophy. These two findings were both diagnosed as manifestations of choroidal ischaemia, the former due to choroidal artery occlusion, the latter to transient insufficiency of choroidal circulation, which reflects the lobular pattern of the choriocapillaris.- - - - - - - - - - ranking = 0.66666666666667keywords = aldosteronism (Clic here for more details about this article) |
5/5. Elevation of plasma renin activity during pregnancy and rupture of a dissecting aortic aneurysm in a patient with primary aldosteronism.This is a case report of a 37-year-old Japanese woman with primary aldosteronism who was found to have high plasma renin activity during toxemia of pregnancy and who died of a dissecting aneurysm of the aorta about 2 years later. The autopsy findings showed cystic medial necrosis in the aorta and a right adrenocortical adenoma. The dissecting aneurysm in this case is probably related to hypertension and cystic medial necrosis. A definite diagnosis of primary aldosteronism cannot be made during toxemia of pregnancy, and it is necessary to do serial determinations of plasma renin activity and plasma aldosterone concentration after delivery to confirm the diagnosis.- - - - - - - - - - ranking = 1keywords = aldosteronism (Clic here for more details about this article) |