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Angeles City
COLLEGE OF ALLIED MEDICAL PROFESSIONS
HYPERALDOSTERONISM
Submitted by:
Group 7
BSMT 3-E
Group Leader: Collado, Marc Jeffrey S.
Members: Concepcion, Vixy
Roque, Theresa
.
Submitted to:
Mr. Raphael Tiongco
Mr. Franz Cabrera
CC03 Laboratory Professors
I.
II.
INTRODUCTION
Aldosterone controls the retention of Na+, CP, and H2O, the excretion of K+ and H+ and,
therefore, the amount of fluid in the body. Aldosterone production is controlled by the
renin-angiotensin system of the kidney.
Angiotensin II stimulates the secretion of aldosterone and is a potent vasoconstrictor.
Steroid Hormone
18-hydroxysteroid dehydrogenase enzyme needed fpr the synthesis of aldosterone
Function of aldosterone is to increase salt and water conservation through renal tubular
retention of Na+ and Cl~ and H2O secondarily and to promote excretion of K+ and H+.
1) Overall effect is vasoconstriction, which increases blood pressure (BP) and Na+
retention, which promotes increase in blood volume (BV).
2) Increase in BP and BV suppresses secretion of renin and, thus, the synthesis of
aldosterone.
HYPERALDOSTERONISM
A 57 year old lady has complaints of uncontrolled blood pressure for a year despite using
multiple combinations of anti-hypertensive drugs. Transabdominal ultrasonography revealed
bilateral simple renal cortical cysts and a solid mass of 3.1x2.8 cm in the right adrenal gland.
Lab tests are as follows:
FBS: 107 (85-120 mg/dL)
Creatinine: 1.6 (0.8 1.9 mg/dL)
Sodium: 140 (135-145 mmol/L)
Potassium: 3.9 (3.5-5.4 mmol/L)
Serum Aldosterone: 48.3 (4-31 ng/dL)
Plasma Renin Activity: 0.006 (0.15 2.33 ng/mL/hr)
III.
2. What are the abnormal results? Give the indication of these results.
Hypertension
Hypokalemia
Mild Hypernatremia
Metabolic alkalosis
SECONDARY
PSEUDOALDOSTERONISM
(Liddle Syndrome)
PLASMA
ADOSTERONE
Elevated aldosterone
Elevated aldosterone
Low aldosterone
PLASMA
RENIN
Low renin
Elevated renin
SIGNS &
SYMPTOMS
Hypertension ,
hypokalemia, mild
hypernatremia and
metabolic alkalosis
Malignant
hypertension,
hypokalemia, and renal
artery stenosis
CONFIRMATORY TESTS
Saline Suppression Test - It involves infusing 2 L of 0.9% saline over 4
hours, or by administering 10-12 mg NaCl tablets daily for 3 days.
o Expected result: (+) >10 ng/dL PAC
IV.
Reference
c. Reference ranges: Adult supine, 3-16 ng/dL; adult upright, 7-30 ng/dL;
blood levels of aldosterone are higher in the morning
d. Clinical significance
1) Hyperaldosteronism