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Pathology
Excess aldosterone production from the adrenal cortex (primary)
Aetiology
Adrenocortical adenoma (60%): F>>M. 3-5th Decade
Idiopathic/hyperplasia (40%): M=F, 5-7th decade
Adrenal Ca: older group, F>M
Signs
Moderate signs of hypertension
Symptoms
Usually related to hypertension. Rarely myopathy, weakness, polyuria/polydipsia due to kidneys being unable to concentrate urine
Investigations
Bloods: FBC, U&E, Aldosterone (elevated), plasma renin, (>30-50ng/ml/h).
Imaging: CT/MRI to identify adenomas if biochemical tests suspicious
Treatment
Medical: Aldosterone antagonists e.g. Spironolactone or Eplerenone
Surgical: Resection
Prognosis
Adrenalectomy can cure ~ 75% of cases
All associated with poorly treated hypertension
Key Facts
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Key References
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