[Difficulty in diagnosis of primary hyperaldosteronism as the cause of resistant hypertension and severe hypokalemia--case report].

The most common endocrinological cause of secondary hypertension is primary hyperaldosteronism. Despite great progress in laboratory and imaging techniques, its identification is often difficult. We report the case of the 52-year-old man with resistant hypertension and severe hypokalemia. Renovascular hypertension, Cushing syndrome and pheochromocytoma were excluded as potential causes of drug-resistant hypertension in the presented case. Renal potassium excretion was significantly high. The results of plasma aldosterone concentration measured in supine position as well as in standing position were ambiguous. Computed tomography revealed abnormal round solid mass with a maximum diameter of 11 mm in the left adrenal. As there were not diagnostic results of laboratory research and ambiguous character of pathological structure in research computed tomography we have decided to carry adrenal cortex scintigraphy with iodomethyl-norcholesterol 131I. The result of this research was consistent with left adrenal scan of computed tomography and left adrenal adenoma has been confirmed. Normal blood pressure and normokalemia were restored after surgical treatment.