It is an endocrine disorder caused by adrenal cortical tumors or hyperplasia, leading to increased aldosterone secretion, sodium and water retention, and expansion of body fluid volume, which inhibits the renin-angiotensin system. Based on different disease causes, it can be classified into aldosterone-producing adenoma, idiopathic hyperaldosteronism, aldosterone-producing carcinoma, tumors with ectopic aldosterone secretion, and glucocorticoid-remediable aldosteronism. Aldosterone-producing adenoma is the most common, accounting for approximately 60–90%.

bubble_chart Diagnosis

1. Medical History and Symptoms:

Early symptoms include mild grade II hypertension, often accompanied by muscle weakness and periodic paralysis. There may also be numbness in the extremities, hand and foot convulsions, thirst, polyuria, increased nocturia, palpitations, and shortness of breath.

2. Physical Examination Findings:

Elevated blood pressure, arrhythmia, decreased muscle strength and tone in the limbs, or hand and foot convulsions.

3. Auxiliary Examinations:

Hypokalemia, high-normal or elevated blood sodium levels; hyperkaluria, hyponatriuria, alkalosis; increased blood and urine aldosterone levels; positive spironolactone test; low-sodium test may improve hypokalemia and hypertension, while high-sodium test may exacerbate hypokalemia in mild cases. B-ultrasound, CT, MRI, and 131I-labeled cholesterol adrenal scanning can detect tumors or hyperplasia.

4. Differential Diagnosis:

Should be differentiated from primary hypertension, renal hypertension, hypercortisolism, pheochromocytoma, and congenital 11β-hydroxysteroid dehydrogenase deficiency.

Patients with adenomas should undergo surgical resection. For hyperplasia, subtotal adrenalectomy can be performed. For those who cannot undergo surgery, spironolactone 120-240mg/d may be used, and calcium channel blockers, angiotensin-converting enzyme inhibitors, or aminoglutethimide can be added.