A 79-year Old Man with Hypertension, Hypokalemia, Hyporeninemia and Hypoaldosteronemia Similar to Liddle's Syndrome

Abstract

A 79-year old man with hypertension, hypokalemic metabolic alkallosis, hyporeninemia and hypoaldosteronemia was studied. Blood pressure fell and serum potassium returned to normal after sodium restriction and the administration of triamterene. Serum DHEA, DOC, corticosterone, 18-OH-corticosterone, 11-deoxy-cortisol, cortisol were within normal range. Adrenal CT scanning did not reveal an adrenal tumor. The excretions of urinary kallikrein and prostaglandin E₂ were within the normal range. Although an atrophic juxtaglomerular apparatus and arteriosclerotic change were observed by renal biopsy, there was no evidence of hypokalemic nephropathy. From these results, it is suggested that this patient has a defect in handling sodium and potassium in the distal tubules. This is similar to that observed in Liddle's syndrome.