Diagnostic approach to patients with primary hyperaldosteronism.

We report the case of a 38-year-old patient with primary hyperaldosteronism. The diagnosis was made by the demonstration of a non-suppressible high aldosterone level in association with a hypokalemia, an inappropriate kaliuresis and low plasma renin activity. As the choice of the therapeutic approach is dictated by the subtype, further investigation was needed. Using a number of hormonal studies and noninvasive imaging techniques, we could establish the diagnosis of adrenocortical adenoma. Histological examination confirmed our diagnosis. We further discuss briefly the characteristics of the four subtypes of primary hyperaldosteronism and show that the used biochemical markers and imaging techniques are able to differentiate them.