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KMID : 0356620090240030201
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Journal of Korean Society of Endocrinology
2009 Volume.24 No. 3 p.201 ~ p.205
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A Case of Persistent Hyperkalemia After Unilateral Adrenalectomy for Aldosterone-Producing Adenoma
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Yang Min-Jae
Kim Dae-Jung
Chung Yoon-Sok
Lee Kwan-Woo
Lee Tae-Hui
Kim Jang-Hee
Han Seung-Jin
Kim Hae-Jin
Lee Min-Suk
Kim Eun-Kyung
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Abstract
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Primary aldosteronism is a syndrome characterized by various clinical features that are due to excessive autonomous aldosterone secretion not sustained by the activation of the renin-angiotensin system. Aldosterone-producing adrenal adenoma is found in approximately 35% of the patients who suffer with primary aldosteronism. Laparoscopic adrenalectomy is the standard treatment for aldosterone-producing adrenal adenoma, and the result of this operation is normalization of the serum potassium and plasma aldosterone concentrations, as well as correcting the plasma renin activity in most cases. However, it is known that some of the patients with aldosterone-producing adrenal adenoma show transient hyperkalemia postoperatively due to the reversible suppression of the renin-aldosterone axis. We recently experienced the case of a 54-year-old woman with an aldosterone-producing adrenal adenoma, and she presented with severe hyperkalemia after unilateral adrenalectomy. Compared with the previously reported cases that showed transient suppression of the rennin-aldosterone axis for less than 7 months, our patient revealed a prolonged episode of hyperkalemia for 8 months postoperatively, and this required continuous mineralocorticoid replacement.
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KEYWORD
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aldosterone-producing adenoma, hyporeninemic hypoaldosteronism, postoperative hyperkalemia
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