A 32-year-old woman is diagnosed with hypertension, hypernatremia, hypokalemia, and alkalosis. Measurements of plasma glucocorticoid levels show them to be within the normal range; however, renin and angiotensin II levels are suppressed. Ultrasound indicates the possible existence of an adrenal cortical mass. These symptoms are likely due to excess production of which of the following hormones?

Question

Quizplus · Accepted Answer

The symptoms and findings are consistent with primary hyperaldosteronism (Conn's syndrome), which is characterized by excess production of aldosterone, leading to hypertension, hypernatremia, hypokalemia, and metabolic alkalosis. The presence of an adrenal mass supports this diagnosis.  The principal mineralocorticoid, produced by zona glomerulosa cells of the adrenals, is aldosterone. Synthesis of aldosterone is primarily controlled by the rennin-angiotensin system and is thus involved in control of blood pressure. Reduced or inhibited function in the renin-angiotensin system will lead to excess aldosterone release from the adrenals. Aldosterone causes sodium reabsorption by the kidneys which in turn regulates water balance and leads to increases in blood pressure by increasing fluid volume manifest with the hypertension and hypernatremia evident in this patient.

A 32-Year-Old Woman Is Diagnosed with Hypertension, Hypernatremia, Hypokalemia, and Alkalosis