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Primary Aldosteronism: Case Observed in a Patient Subjected Previously to Thoracolumbar Sympathectomy

Primary Aldosteronism: Case Observed in a Patient Subjected Previously to Thoracolumbar... Abstract Following Conn's original description1-3 of the syndrome of primary aldosteronism in 1955, more than 50 patients have been reported in whom the disease was clearly present.4,5 We feel that the patient described in this report is of unusual interest for several reasons: She survived 8 years of severe hypertension before the discovery and removal of an adrenal cortical adenoma. As in another instance, our patient was subjected to bilateral thoracolumbar sympathectomies several years prior to the diagnosis of primary aldosteronism. Chlorothiazide, used in our patient in an attempt to lower her blood pressure prior to the discovery of her adrenal adenoma, appeared to precipitate symptoms of generalized muscular weakness such as have been associated with primary aldosteronism.4,5 Since the use of chlorothiazide and related drugs in the treatment of hypertension is by now widespread, it is possible that investigation of other patients who demonstrate similar responses to References 1. Conn, J. W.: Primary Aldosteronism: A New Clinical Syndrome , J. Lab. Clin. Med. 45:3-17, 1955. 2. Conn, J. W.: Progress Report: Primary Aldosteronism , J. Lab. Clin. Med. 45:661-664, 1955. 3. Conn, J. W., and Louis, L. H.: Primary Aldosteronism: A New Clinical Entity , Ann. Intern. Med. 44:1-15, 1956.Crossref 4. Delorme, P., and Genest, J.: Primary Aldosteronism: A Review of the World Literature from 1955 to June, 1958 , Canad. Med. Ass. J. 81:893-902, 1959. 5. Conn, J. W.: Evolution of Primary Aldosteronism as a Highly Specific Clinical Entity , J.A.M.A. 172:1650-1653, 1960.Crossref 6. Blakemore, W. S.; Murphy, J. J.; Pendergrass, H. P., and Greening, R.: Carbon Dioxide as a Contrast Medium in Roentgenography , J.A.M.A. 167:310-311, 1958.Crossref 7. Ross, E. J.: Aldosterone in Clinical and Experimental Medicine , Springfield, Ill., Charles C Thomas, Publisher, 1959. 8. Gale, I.; Jory, H. I.; Mulligan, L., and Woollen, J. W.: Primary Aldosteronism: A Case with Severe Hypertension , Amer. J. Med. 28:311-322, 1960.Crossref 9. Garcia Llaurado, J.; Neher, R., and Wettstein, A.: Chemical Identification of Aldosterone in Postoperative Urine , Clin. Chem. Acta 1:236-241, 1956.Crossref 10. Dustan, H. P.; Corcoran, A. C., and Page, I. H.: Renal Function in Primary Aldosteronism , J. Clin. Invest. 35:1357-1363, 1956.Crossref 11. Skanse, E.; Moller, F.; Gydell, K.; Johansson, S., and Wulff, H. B.: Observations on Primary Aldosteronism , Acta Med. Scand. 158:181-192, 1957.Crossref 12. Hellem, A. J.: Primary Aldosteronism , Acta Med. Scand. 155:271-274, 1956.Crossref 13. Earle, D. P.; Sherry, S.; Eichna, L. W., and Conan, N. J.: Low Potassium Syndrome Due to Defective Renal Tubular Mechanisms of Handling Potassium , Amer. J. Med. 11:283-301, 1951.Crossref 14. Van Buchem, F. S. P.: The Electrocardiogram and Potassium Metabolism: Electrocardiographic Abnormalities in Primary Aldosteronism and Familial Periodic Paralysis , Amer. J. Med. 23:376-384, 1957.Crossref 15. Black, D. A. K., and Milne, M. D.: Experimental Potassium Depletion in Man , Clin. Sci. 11:379-415, 1952. 16. Chalmers, T. M.; Fitz-Gerald, M. G.; James, A. H., and Scarborough, H.: Conn's Syndrome with Severe Hypertension , Lancet 1:127-132, 1956.Crossref 17. Milne, M. D.; Muehrocke, R. C., and Aird, I.: Primary Aldosteronism , Quart. J. Med. 25:539-563, 1956. 18. Goldberg, M.: Personal communication to the authors. 19. Cohen, T.: Hypokalemic Muscle Paralysis Associated with Administration of Chlorothiazide , J.A.M.A. 170:2083-2085, 1959.Crossref 20. Mattox, V. R., and Lewbart, M. L.: The Determination of Aldosterone is the Urine , J. Clin. Endocr. 19:1151-1161, 1959.Crossref 21. Garrod, O.; Nabarro, J. D. N.; Pawan, G. L. S., and Walker, G.: Metabolic Effects of 9-α-Fluorohydrocortisone and of Cortisone in Adrenal Insufficiency , Lancet 2:367-370, 1955.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Primary Aldosteronism: Case Observed in a Patient Subjected Previously to Thoracolumbar Sympathectomy

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Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1962.03620130057009
Publisher site
See Article on Publisher Site

Abstract

Abstract Following Conn's original description1-3 of the syndrome of primary aldosteronism in 1955, more than 50 patients have been reported in whom the disease was clearly present.4,5 We feel that the patient described in this report is of unusual interest for several reasons: She survived 8 years of severe hypertension before the discovery and removal of an adrenal cortical adenoma. As in another instance, our patient was subjected to bilateral thoracolumbar sympathectomies several years prior to the diagnosis of primary aldosteronism. Chlorothiazide, used in our patient in an attempt to lower her blood pressure prior to the discovery of her adrenal adenoma, appeared to precipitate symptoms of generalized muscular weakness such as have been associated with primary aldosteronism.4,5 Since the use of chlorothiazide and related drugs in the treatment of hypertension is by now widespread, it is possible that investigation of other patients who demonstrate similar responses to References 1. Conn, J. W.: Primary Aldosteronism: A New Clinical Syndrome , J. Lab. Clin. Med. 45:3-17, 1955. 2. Conn, J. W.: Progress Report: Primary Aldosteronism , J. Lab. Clin. Med. 45:661-664, 1955. 3. Conn, J. W., and Louis, L. H.: Primary Aldosteronism: A New Clinical Entity , Ann. Intern. Med. 44:1-15, 1956.Crossref 4. Delorme, P., and Genest, J.: Primary Aldosteronism: A Review of the World Literature from 1955 to June, 1958 , Canad. Med. Ass. J. 81:893-902, 1959. 5. Conn, J. W.: Evolution of Primary Aldosteronism as a Highly Specific Clinical Entity , J.A.M.A. 172:1650-1653, 1960.Crossref 6. Blakemore, W. S.; Murphy, J. J.; Pendergrass, H. P., and Greening, R.: Carbon Dioxide as a Contrast Medium in Roentgenography , J.A.M.A. 167:310-311, 1958.Crossref 7. Ross, E. J.: Aldosterone in Clinical and Experimental Medicine , Springfield, Ill., Charles C Thomas, Publisher, 1959. 8. Gale, I.; Jory, H. I.; Mulligan, L., and Woollen, J. W.: Primary Aldosteronism: A Case with Severe Hypertension , Amer. J. Med. 28:311-322, 1960.Crossref 9. Garcia Llaurado, J.; Neher, R., and Wettstein, A.: Chemical Identification of Aldosterone in Postoperative Urine , Clin. Chem. Acta 1:236-241, 1956.Crossref 10. Dustan, H. P.; Corcoran, A. C., and Page, I. H.: Renal Function in Primary Aldosteronism , J. Clin. Invest. 35:1357-1363, 1956.Crossref 11. Skanse, E.; Moller, F.; Gydell, K.; Johansson, S., and Wulff, H. B.: Observations on Primary Aldosteronism , Acta Med. Scand. 158:181-192, 1957.Crossref 12. Hellem, A. J.: Primary Aldosteronism , Acta Med. Scand. 155:271-274, 1956.Crossref 13. Earle, D. P.; Sherry, S.; Eichna, L. W., and Conan, N. J.: Low Potassium Syndrome Due to Defective Renal Tubular Mechanisms of Handling Potassium , Amer. J. Med. 11:283-301, 1951.Crossref 14. Van Buchem, F. S. P.: The Electrocardiogram and Potassium Metabolism: Electrocardiographic Abnormalities in Primary Aldosteronism and Familial Periodic Paralysis , Amer. J. Med. 23:376-384, 1957.Crossref 15. Black, D. A. K., and Milne, M. D.: Experimental Potassium Depletion in Man , Clin. Sci. 11:379-415, 1952. 16. Chalmers, T. M.; Fitz-Gerald, M. G.; James, A. H., and Scarborough, H.: Conn's Syndrome with Severe Hypertension , Lancet 1:127-132, 1956.Crossref 17. Milne, M. D.; Muehrocke, R. C., and Aird, I.: Primary Aldosteronism , Quart. J. Med. 25:539-563, 1956. 18. Goldberg, M.: Personal communication to the authors. 19. Cohen, T.: Hypokalemic Muscle Paralysis Associated with Administration of Chlorothiazide , J.A.M.A. 170:2083-2085, 1959.Crossref 20. Mattox, V. R., and Lewbart, M. L.: The Determination of Aldosterone is the Urine , J. Clin. Endocr. 19:1151-1161, 1959.Crossref 21. Garrod, O.; Nabarro, J. D. N.; Pawan, G. L. S., and Walker, G.: Metabolic Effects of 9-α-Fluorohydrocortisone and of Cortisone in Adrenal Insufficiency , Lancet 2:367-370, 1955.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1962

References