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J Korean Soc Endocrinol. 2005 Oct;20(5):502-506. Korean. Case Report.
Suh J , Koh G , Park KY , Hong J , Chon S , Oh S , Woo JT , Kim SW , Kim JW , Kim YS .
Department of Internal medicine, Kyung Hee university College of Medicine, Seoul, Korea.
Research Institute of Endocrinology, Kyung Hee university College of Medicine, Seoul, Korea.
Department of Endocrinology, College of Medicine, Konyang University, Daejeon, Korea.

Primary aldosteronism is due to either a unilateral adrenal adenoma or bilateral hyperplasia of the adrenal cortex in most cases. A unilateral adrenalectomy in hypertensive and hypokalemic patients, with a well-documented adrenal adenoma, is usually followed by the correction of hypokalemia in all subjects, with the cure of hypertension in 60 to 87% of patients. Here, a unique case, in which a unilateral adrenalectomy for the removal of an adrenal adenoma was followed by severe hyperkalemia, low levels of plasma renin activity and serum aldosterone, suggestive of chronic suppression of the renin-aldosterone axis, is reported. In a follow-up Lasix stimulation test on the 70th day after surgery, the suppression of the renin-aldosterone axis was resolved, indicating the suppression was transient. Patients undergoing a unilateral adrenalectomy for an aldosterone-producing adenoma should be closely followed up to avoid severe hyperkalemia.

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