Mineralocorticoid excess
The principal mineralocorticoid
secreted by the adrenal gland is aldoste-rone. Increased production may result
from a primary defect of the adre-nal gland (primary hyperaldosteronism) or from
factors that activate the renin–angiotensin system (secondary
hyperaldosteronism). Hypokalaemia and hypertension are typical features.
Characterized by hypokalaemia and
hypertension. There is suppression of the renin–angiotensin system with low
plasma renin levels. Children may have no symptoms, the diagnosis being
established after the incidental finding of hypertension. Chronic hypokalaemia
may result in muscle weak-ness, fatigue, and poor growth.
· Bilateral adrenal hyperplasia
· Adrenal tumours
· Glucocorticoid-remediable
hyperaldosteronism
This occurs when excess
aldosterone production is secondary to elevated renin levels. Hypertension may
or may not be present.
• Renovascular malformations/stenosis
· Primary hyperreninaemia
· Juxtaglomerular tumour
· Wilm’s tumour
· Post-renal transplantation
· Urinary tract obstruction
· Phaeochromocytoma
· Hepatic cirrhosis
· Congestive cardiac failure
· Nephrotic syndrome
· Bartter’s syndrome
· Anorexia nervosa
Syndrome of apparent
mineralocorticoid excess: type 1 and type 2 variants
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