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Renin-Secreting Renal Neoplasm and Hypertension with Hypokalemia

RICHARD L. EDDY, M.D.; and SANTIAGO A. SANCHEZ, M.D.
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▸Requests for reprints should be addressed to R. L. Eddy, M.D., Scott and White Clinic, Temple, Tex.


Temple, Texas


Ann Intern Med. 1971;75(5):725-729. doi:10.7326/0003-4819-75-5-725
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Antihypertensive medication was ineffective in a young woman with severe, progressive hypertension of 6 years' duration. Serial excretory urography, catecholamine excretion, aldosterone excretion, and serum potassium levels were normal until hypokalemia was noted. Further evaluation showed a renal neoplasm and elevated plasma renin activity and aldosterone excretion. Renovascular embarrassment was not found by radioactive hippuran or impedance renography. Nephrectomy promptly initiated a dramatic fall in the blood pressure and in plasma renin activity. The tumor was characterized morphologically as a hemangiopericytoma that contained high concentrations of renin activity and Bowie-positive granules. Postoperatively, the patient has been normotensive and normokalemic without medication. Renin activity in the peripheral plasma is normal.

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