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"Normotensive" Primary Aldosteronism

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This study was supported by NIH Grants HL21112 and AM07119.

University of Southern CaliforniaLos Angeles, California

Ann Intern Med. 1978;88(5):655-656. doi:10.7326/0003-4819-88-5-655
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Hypokalemia and hypertension are the most important features of primary aldosteronism. In rare instances, patients with this disorder have normal serum potassium levels, but this is usually attributed to sodium restriction. Hypertension, however, has been commonly found (1-5).

We describe here the case of a patient with hypokalemia, inappropriate kaliuresis, and persistently normal blood pressure. Primary aldosteronism was diagnosed by the fludrocortisone suppression test, and spironolactone therapy normalized the electrolyte imbalance.

Hypokalemia was first documented in December 1975 in a 45-year-old black woman evaluated for depression. Depression worsened, and she was hospitalized in the summer of 1976 for 16 weeks.



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