• Internal medicine · Oct 2023

    Case Reports

    Usefulness of Alternative Therapy with Hydrocortisone in the Postoperative Management of Severe Primary Aldosteronism: A Case Report.

    • Masahiro Asakawa, Noriko Takagi, Daisuke Hamada, Yuko Yamasaki, Yutaro Takaku, Masahiro Kawada, Taro Murata, and Hidenori Katsuta.
    • Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, Japan.
    • Intern. Med. 2023 Oct 15; 62 (20): 298129882981-2988.

    AbstractMineralocorticoid deficiency (MD) with hyperkalemia is an important complication of adrenalectomy in patients with primary aldosteronism (PA). We herein report a 52-year-old man with refractory hypertension, hypokalemia, and severe renal dysfunction due to PA caused by a right adrenal adenoma. His estimated glomerular filtration rate (eGFR) transiently increased immediately after adrenalectomy but then gradually declined, and he developed hyperkalemia. A postoperative endocrine examination revealed MD. Considering the patient's hypertension and severe renal dysfunction, we administered hydrocortisone instead of fludrocortisone, which improved the hyperkalemia and stopped the decline in the eGFR. Alternative therapy with hydrocortisone may be useful in such patients with MD.

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