| Hypertension in a patient with aldosterone deficiency. | |
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MedLine Citation:
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PMID: 15901525 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe a patient with aldosterone synthase deficiency, who presented with failure to thrive, hypovolemic hyponatremia, and the unexpected finding of hypertension. METHODS: We present a case report, review the related literature, and outline a possible mechanism for the concomitant occurrence of high blood pressure and hyponatremia in this patient. RESULTS: A 5-month-old infant with unambiguous female genitalia was admitted to our hospital with failure to thrive and hyponatremia. Her blood pressure was 115/88 mm Hg (>95% for age). The serum sodium concentration was 123 mEq/L (normal for age, >130), and the potassium level was 5.3 mEq/L (normal, 3.5 to 5.3). A direct renin measurement by immunochemiluminescence assay was 11,400 microU/mL (normal, <5), and the aldosterone level was 4 ng/dL (normal, 2 to 70). These findings indicated a diagnosis of aldosterone synthase deficiency. Treatment with fludrocortisone and sodium chloride was begun, but the hypertension worsened. Therapy with an angiotensin-converting enzyme inhibitor was transiently required. CONCLUSION: Angiotensin II, a potent vasoconstrictor, is an intermediate in the renin-angiotensin system. We believe that this protein was the cause of the hypertension in the setting of aldosterone deficiency in our patient. |
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Authors:
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Leslie Touger; Mark Joseph; Khalid S Hasan |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Volume: 11 ISSN: 1530-891X ISO Abbreviation: Endocr Pract Publication Date: 2005 Mar-Apr |
Date Detail:
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Created Date: 2005-05-19 Completed Date: 2005-07-12 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: United States |
Other Details:
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Languages: eng Pagination: 104-7 Citation Subset: IM |
Affiliation:
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Department of Endocrinology and Nephrology, Phoenix Children's Hospital, Phoenix, Arizona 85016-7710, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aldosterone Synthase
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deficiency Angiotensin-Converting Enzyme Inhibitors / therapeutic use Antihypertensive Agents / therapeutic use Blood Pressure / drug effects Drug Therapy, Combination Failure to Thrive Female Fludrocortisone / adverse effects, therapeutic use Humans Hypertension / drug therapy, etiology*, physiopathology Hypoaldosteronism / complications*, etiology, physiopathology Hyponatremia / etiology Infant Sodium Chloride / adverse effects, therapeutic use Steroid Metabolism, Inborn Errors / complications |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 127-31-1/Fludrocortisone; 7647-14-5/Sodium Chloride; EC 1.14.15.4/Aldosterone Synthase |
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