IDIOPATHIC HYPERPLASIA OF THE ADRENAL-GLAND BEHAVING LIKE AN ALDOSTERONE-PRODUCING ADENOMA

Primary hyperaldosteronism (adrenal adenoma and idiopathic hyperplasia ) is a disorder with hypertension, hypokalemia, elevated serum aldoste rone and suppressed plasma renin activity. Hyperplasia is managed medi cally whereas adenomas are treated surgically. Selective adrenal venou s catheterization and aldosterone measurement is a useful tool in maki ng the distinction in 95% of cases. We report a case of bilateral idio pathic hyperplasia of the adrenal glands adequately treated with medic ations for 6 years followed by worsening. Selective catheterization wa s consistent with a right sided adenoma. Surgical removal of the right adrenal gland alleviated her symptoms. Pathological examination showe d focal nodular hyperplasia. We propose that in the course of the dise ase the focal hyperplastic nodule became autonomous and behaved like a n adenoma. Monitoring of patients with adrenal hyperplasia for recurre nce of symptoms is prudent as surgery is beneficial in patients who de velop an autonomous nodule. (C) 1997, Editrice Kurtis.