Primary aldosteronism is one of the causes of hypertension that can be corrected surgically. During the period from June 1992 through March 1995, 4cases, 1 man and 3 women, with primary aldosteronism underwent adrenalectomy at department of
Surgery,
Inje University Paik Hospital, Seoul. The mean age was 47 years with a range of 38 and 53 years .The mean systolic / diastolic blood pressure was 180/125 mmHg. Symptoms included headache, weakness, urinary frequency and palpitation. Serum
potassium
level was below 3.5 mEq/L patients. In all cases, the diagnosis of primary aldosteronism was made by low plasma renin activity and high plasma aldosterone level. Plasma renin activity was in the range of 0.03 ~0.11ng/ml/hr (normal range:
0.15~2.33
on
supine position, 1.31~3.95 on erect position) and plasma aldosterone level 232~674pg/ml (normal range: 20~130 on supine position, 30~210 on erect position). Urinary potassium excretion exceeded 30 mEq/day in 3 cases. All the adrenal lesions could
be
detected by abdominal CT scanning. Selective adrenal venous sampling was performed in 1 cases with positive result. Unilateral adrenalectomy was performed via trans-abdominal route in all cases with no postoperative complications. Postoperative
blood
pressure was maintained at 130/70 mmHg in 3 cases without any antihypertensive medications, although one case required a small-dose of antihypertensive drug. Plasma aldosterone level as well as serum potassium level was normalized
postoperatively.
The
adrenal lesions were confirmed pathologically as adrenal adenoma in all cases.
Freoperative evaluation of patients with primaly aldosteronism using current modes allows the differentiation of the surgically correctable lesion (adenoma) from the other etiological subgroups. Adrenaletomy cures hypokalemia and hypertension
when
the
cause is adenoma.
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