HORMONAL CHARACTERISTICS OF PRIMARY ALDOSTERONISM DUE TO UNILATERAL ADRENAL-HYPERPLASIA

A case of unilateral adrenocortical hyperplasia is presented. A 46-yea r-old woman with a 7-year history of hypertension and a 1-year-history of hypokalemia was diagnosed with primary aldosteronism. Computed tom ography, magnetic resonance imaging, venous sampling and adosterol sci ntigraphy exhibited a functioning left adrenal mass. The plasma aldost erone concentration increased markedly when furosemide with upright po sture and either captopril or adrenocorticotropin were administered. P lasma renin activity was suppressed below the detectable range. Aldost erone secretion displayed a circadian rhythm and was not suppressed by dexamethasone administration. The resected left adrenal mass was path ologically diagnosed as adrenocortical nodular hyperplasia. Unilateral adrenal hyperplasia involving the zona glomerulosa rarely has been re ported, with varying and incompletely characterized hormonal character istics. This case report: and literature review suggest unilateral adr enal hyperplasia as a rare cause of hyperaldosteronism with characteri sties intermediate between idiopathie hyperaldosteronism and aldostero ne-producing adrenocortical adenoma, resembling the functional feature s of the adenoma more closely. (J. Endocrinol. Invest. 21: 531-536, 19 98) (C) 1998, Editrice Kurtis.