Hypertension in a patient with aldosterone deficiency
| Autor: | Mark Joseph, Khalid S. Hasan, Leslie Touger |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Steroid Metabolism Inborn Errors Endocrinology Diabetes and Metabolism MEDLINE Angiotensin-Converting Enzyme Inhibitors Blood Pressure Sodium Chloride chemistry.chemical_compound Endocrinology Pharmacotherapy medicine Cytochrome P-450 CYP11B2 Humans Intensive care medicine Antihypertensive Agents Aldosterone business.industry nutritional and metabolic diseases Infant Steroid Metabolism General Medicine medicine.disease Hypoaldosteronism Failure to Thrive Unexpected finding chemistry Fludrocortisone Failure to thrive Hypertension Drug Therapy Combination Female medicine.symptom Hyponatremia business Aldosterone deficiency |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 11(2) |
| ISSN: | 1530-891X |
| Popis: | To describe a patient with aldosterone synthase deficiency, who presented with failure to thrive, hypovolemic hyponatremia, and the unexpected finding of hypertension.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.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.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. |
| Databáze: | OpenAIRE |
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