Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Primary Aldosteronism due to Unilateral Adrenal Microadenoma in an Elderly Patient: Efficacy of Selective Adrenal Venous Sampling
Yoshiaki TamuraJun-ichiro AdachiYuko ChibaSeijiro MoriKazuhiro TakedaYutaka KasuyaTakeo MurayamaMotoji SawabeHironobu SasanoAtsushi ArakiHideki ItoToshiyuki Horiuchi
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JOURNAL OPEN ACCESS

2008 Volume 47 Issue 1 Pages 37-42

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Abstract

We encountered a case of drug-resistant hypertension and hypokalemia. Laboratory data suggested primary aldosteronism (PA). Computed tomography imaging appeared normal for a long duration with a left-sided nodule appearing far later; adrenal scintigraphy was first normal, and the second test showed right-sided uptake. However, a repeat selective adrenal venous sampling (SAVS) indicated a left-sided lateralization of the hypersecretion of aldosterone. Left adrenectomy was performed, and his clinical symptoms improved. The histopathological findings demonstrated the aldosterone-producing microadenoma with secondary micronodules. In conclusion, SAVS should be performed to determine the laterality of PA with obscure CT imaging.

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© 2008 by The Japanese Society of Internal Medicine
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