Malignant Hypertension in a Patient with Primary Aldosteronism with Elevated Active Renin Concentration

Kiyoshi Oka, Koichi Hayashi, Tomonori Nakazato, Taichi Suzawa, Keiji Fujiwara, Takao Saruta

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A 40-year-old male, with a past history of hypertension but receiving no medical treatment, was referred. He manifested malignant hypertension (190/130 mmHg; Keith-Wagener III), renal dysfunction (serum creatinine, 3.8 mg/dl), and elevated plasma aldosterone (450 pg/ml) and active renin concentration (ARC, 104 pg/ml). His blood pressure was controlled with multiple antihypertensive agents and ARC thus decreased (4.3 pg/ml), but aldosterone remained elevated. Abdominal magnetic resonance imaging (MRI) revealed a right adrenal adenoma, and aldosterone-producing adenoma was confirmed by adrenal venous sampling. Primary aldosteronism very rarely develops to malignant hypertension, and even in that case ARC is suppressed. Therefore this is a rare case of primary aldosteronism complicated with malignant hypertension and high ARC.

Original languageEnglish
Pages (from-to)700-704
Number of pages5
JournalInternal Medicine
Issue number10
Publication statusPublished - 1997 Jan 1



  • Adrenal adenoma
  • Aldosterone
  • Hemolytic anemia
  • Hypertension
  • Renal injury
  • Renin

ASJC Scopus subject areas

  • Internal Medicine

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