Secondary hyperaldosteronism history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]
Overview
The hallmark of Secondary hyperaldosteronism is resistant hypertension. A positive history of sponatneous or unprovoked hypokalemia and treatment-resitant/refractory hypertension are suggestive of Secondary hyperaldosteronism. The most common symptoms of Secondary hyperaldosteronism include headaches, facial flushing, vision changes and weakness.
History
Secondary hyperaldosteronism may be suspected in the following scenarios:
- Patients with a history of spontaneous or unprovoked hypokalemia along with hypertension.
- Patients who develop severe and/or persistent hypokalemia while on low to moderate doses of potassium-wasting diuretics.
- Patients with a history of treatment-refractory/-resistant hypertension (HTN).
Patients with profound hypokalemia report fatigue, muscle weakness, cramping, headaches, and palpitations. They can also have polydipsia and polyuria from hypokalemia-induced nephrogenic diabetes insipidus. Long-standing HTN may lead to cardiac, retinal, renal, and neurologic problems, with all the associated symptoms and signs.
Common Symptoms
Common symptoms of secondary hyperaldosteronism include:[1][2][3][4][5][6]
- Headaches
- Facial flushing
- Weakness
- Visual impairment
- Impaired consciousness
- Seizures (hypertensive encephalopathy)
- Constipation
- Polyuria and polydipsia (because of impaired renal concentrating ability)
- Weakness
Less Common Symptoms
Less common symptoms include:[7][8]
References
- ↑ Rubidge CJ, O'Dowd PB, Powell SJ (1973). "Difetarsone in the treatment of Trichuris trichiura infections". S. Afr. Med. J. 47 (23): 991–2. PMID 4714286.
- ↑ Mattsson C, Young WF (2006). "Primary aldosteronism: diagnostic and treatment strategies". Nat Clin Pract Nephrol. 2 (4): 198–208, quiz, 1 p following 230. doi:10.1038/ncpneph0151. PMID 16932426.
- ↑ Di Tullio M, Alli C, Avanzini F, Bettelli G, Colombo F, Devoto MA, Marchioli R, Mariotti G, Radice M, Taioli E (1988). "Prevalence of symptoms generally attributed to hypertension or its treatment: study on blood pressure in elderly outpatients (SPAA)". J Hypertens Suppl. 6 (1): S87–90. PMID 3216243.
- ↑ Unwin RJ, Luft FC, Shirley DG (2011). "Pathophysiology and management of hypokalemia: a clinical perspective". Nat Rev Nephrol. 7 (2): 75–84. doi:10.1038/nrneph.2010.175. PMID 21278718.
- ↑ Bautista J, Gil-Neciga E, Gil-Peralta A (1979). "Hypokalemic periodic paralysis in primary hyperaldosteronism. Subclinical myopathy with atrophy of the type 2A muscle fibers". Eur. Neurol. 18 (6): 415–20. PMID 546663.
- ↑ Bortolotto LA, Cesena FH, Jatene FB, Silva HB (2003). "Malignant hypertension and hypertensive encephalopathy in primary aldosteronism caused by adrenal adenoma". Arq. Bras. Cardiol. 81 (1): 97–100, 93–6. PMID 12908077.
- ↑ Moeller J, Muniz B (1967). "[Hypokalemic ileus and aldosteronism]". Med Klin (in German). 62 (52): 2019–24. PMID 5596496.
- ↑ Failor RA, Capell PT (2003). "Hyperaldosteronism and pheochromocytoma: new tricks and tests". Prim. Care. 30 (4): 801–20, viii. PMID 15024897.