Información del artículo
El hiperaldosteronismo primario es la causa principal de hipertensión secundaria. Su presentación inicial ha cambiado y presenta normopotasemia como expresión de formas hormonales más leves (hiperplasia adrenal idiopática bilateral).
Presentamos un caso de hiperaldosteronismo primario en un hombre de 71 años de edad, sin hipertensión, que presentó debilidad muscular y una concentración de potasio plasmático de 2,6 mEq/l.
El diagnóstico requiere ser confirmado mediante una sobrecarga salina o una prueba con fludrocortisona. La caracterización de los subtipos se realiza con pruebas de imagen y una prueba postural, valoradas conjuntamente.
La espironolactona es la base del tratamiento médico cuando la intervención quirúrgica no está indicada o cuando el paciente la rechaza. Próximamente, el tratamiento del hiperaldosteronismo primario puede modificarse con un nuevo antagonista selectivo de los receptores de la aldosterona, la eplerenona.
Palabras clave:
Hipopotasemia
Aldosterona
Hiperaldosteronismo
Primary hyperaldosteronism is the primary cause of secondary hypertension. Its initial presentation has changed so that is usually manifests with normokalemia as reflection of a milder hormonal forms of the disease (idiopathic bilateral adrenal hyperplasia).
We report a case of primary hyperaldosteronism in a 71-yearold man without hypertension who presented with muscular weakness. The kalemia was 2.6 mEq/l.
The diagnosis requires confirmation by a salt loading or fludrocortisone test. Characterization of subtypes is achieved by joint assessment of imaging and postural stimulation tests.
Spironolactone is still the basis of medical treatment when surgery is not indicated or is refused by the patient. In the near future, the treatment of primary hyperaldosteronism may be modified by a new selective aldosterone receptor antagonist, eplerenone.
Key words:
Hypokalemia
Aldosterone
Hyperaldosteronism
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