Severe hypertension in a ten-year-old boy secondary to an aldosterone-producing tumour identified by adrenal sonography.

Severe hypertension discovered incidentally in a 10 year-old boy was associated with persistent hypokalaemia and metabolic alkalosis. Primary hyperaldosteronism was diagnosed by demonstrating elevated plasma aldosterone levels and increased urinary aldosterone excretion with concomitant depressed plasma renin activity. Adrenal sonography identified a left adrenal adenoma which was removed surgically; normotension and normalization of plasma renin and aldosterone values ensued. This appeared to be the first use in children of sonography to identify adrenal adenoma and it is suggested to be the first step in the differential diagnosis of primary hyperaldosteronism.