Primary aldosteronism is a surgically corectable hypertension. The incidence ranges from 1 to 2% in overall hypertension, 20 patients with primary aldosteronism underwent adrenalectomy at Department of Surgery, College of medicine, Kyung Hee
University,
and the following results were obtained.
1) There were 3 men and 17 women, and the average age was 40.3 years, ranging from 22 years to 59 years.
2) The systolic pressure was 150~200 mmHg, diastolic 100~140mmHg and the average blood pressure was 180/118, and hypertensive history ranged from 3 months to 15 years (average duration of illness were 4years)
3) The sujbect symptoms most frequently reported were polyuria (85%), muscle weakness (85%) and headache (80%) with nocturia, polydipsia, parasthesia, fatigue and palpitation.
4) In all patients, serum potassium concentration ranged from 1.6mEq/L to 3.2mEq/L 9median 2.315mEq/L), and it considered important diagnostic clue.
5) Primary aldosteronism was confirmed diagnostically with low plasma renin activity, high serum aldosterone level and no response to Lasix stimulation test.
6) Abdominal sonography and abdominal computed tomography were performed in all cases, and the tumor was correctly localized 20 cases all in abdominal CT and 11 cases (55%) in abdominal sonography. but venography and arteriography was not
valuable,
performed in one case for the purpose of the tumor localization.
7) IN 13 cases, blood pressure was downward to normal range and hypokalemia were corrected after taken 150~300mg of spironolactone daily for 7 days at least. Therefore spironolactone test was estinmated as effective diagnostic tool.
8) Unilateral adrenalectomy was performed in all cases.
9) The histological findings were 19 adenomas involved 1 double adenoma (with largest dimension ranging from 1 cm to 3cm) and 1 nodular hyperplasia.
10) Tumor size was not related to duration of symptoms.
11) Symptoms, biochemical and endocrinologic laboratory findings were normalized immediately postoperative and on follow up study from 9 days to 1.5 years in 19 cases except one case of nodular hyperplasia.
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