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Spironolactone Hepatitis in Primary Hyperaldosteronism

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The assertions or opinions herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

▸Requests for reprints should be addressed to Shiao Shen, M.D.; P.O. Box 78, Tripler Army Medical Center; Tripler, HI 96859.

Tripler Army Medical Center; Honolulu, Hawaii

Ann Intern Med. 1981;95(6):708-710. doi:10.7326/0003-4819-95-6-708
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Spironolactone, a 17-spirolactone that competitively inhibits aldosterone, is used in treating secondary hyperaldosteronism (1) and is the preferred drug in treating primary hyperaldosteronism (2). Side effects include gastrointestinal, neurologic, dermatologic, and endocrinologic disturbances. Despite the frequent use of spironolactone in patients with liver disease, no liver toxicity has been reported. We report the case of a patient with primary hyperaldosteronism in whom hepatitis developed secondary to spironolactone therapy.

A 53-year-old woman presented in November with hypertension and hypokalemia. She had no medical history, took no medications, and drank no alcohol. Blood pressure was 220/100 mm Hg in both the


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