Elevation of plasma renin activity during pregnancy and rupture of a dissecting aortic aneurysm in a patient with primary aldosteronism.

This is a case report of a 37-year-old Japanese woman with primary aldosteronism who was found to have high plasma renin activity during toxemia of pregnancy and who died of a dissecting aneurysm of the aorta about 2 years later. The autopsy findings showed cystic medial necrosis in the aorta and a right adrenocortical adenoma. The dissecting aneurysm in this case is probably related to hypertension and cystic medial necrosis. A definite diagnosis of primary aldosteronism cannot be made during toxemia of pregnancy, and it is necessary to do serial determinations of plasma renin activity and plasma aldosterone concentration after delivery to confirm the diagnosis.