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Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy

SUMMARY: A 29-year-old primigravida woman with a known history of primary aldosteronism due to a right aldosteronoma presented with uncontrolled hypertension at 5 weeks of estimated gestation of a spontaneous pregnancy. Her hypertension was inadequately controlled with pharmacotherapy which lead to...

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Autores principales: Shekhar, Skand, Haykal, Rasha, Kamilaris, Crystal, Stratakis, Constantine A, Hannah-Shmouni, Fady
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424322/
https://www.ncbi.nlm.nih.gov/pubmed/32755966
http://dx.doi.org/10.1530/EDM-20-0043
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author Shekhar, Skand
Haykal, Rasha
Kamilaris, Crystal
Stratakis, Constantine A
Hannah-Shmouni, Fady
author_facet Shekhar, Skand
Haykal, Rasha
Kamilaris, Crystal
Stratakis, Constantine A
Hannah-Shmouni, Fady
author_sort Shekhar, Skand
collection PubMed
description SUMMARY: A 29-year-old primigravida woman with a known history of primary aldosteronism due to a right aldosteronoma presented with uncontrolled hypertension at 5 weeks of estimated gestation of a spontaneous pregnancy. Her hypertension was inadequately controlled with pharmacotherapy which lead to the consideration of surgical management for her primary aldosteronism. She underwent curative right unilateral adrenalectomy at 19 weeks of estimated gestational age. The procedure was uncomplicated, and her blood pressure normalized post-operatively. She did, however, have a preterm delivery by cesarean section due to intrauterine growth retardation with good neonatal outcome. She is normotensive to date. LEARNING POINTS: Primary aldosteronism is the most common etiology of secondary hypertension with an estimated prevalence of 5–10% in the hypertensive population. It is important to recognize the subtypes of primary aldosteronism given that certain forms can be treated surgically. Hypertension in pregnancy is associated with significantly higher maternal and fetal complications. Data regarding the treatment of primary aldosteronism in pregnancy are limited. Adrenalectomy can be considered during the second trimester of pregnancy if medical therapy fails to adequately control hypertension from primary aldosteronism.
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spelling pubmed-74243222020-08-17 Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy Shekhar, Skand Haykal, Rasha Kamilaris, Crystal Stratakis, Constantine A Hannah-Shmouni, Fady Endocrinol Diabetes Metab Case Rep Unique/Unexpected Symptoms or Presentations of a Disease SUMMARY: A 29-year-old primigravida woman with a known history of primary aldosteronism due to a right aldosteronoma presented with uncontrolled hypertension at 5 weeks of estimated gestation of a spontaneous pregnancy. Her hypertension was inadequately controlled with pharmacotherapy which lead to the consideration of surgical management for her primary aldosteronism. She underwent curative right unilateral adrenalectomy at 19 weeks of estimated gestational age. The procedure was uncomplicated, and her blood pressure normalized post-operatively. She did, however, have a preterm delivery by cesarean section due to intrauterine growth retardation with good neonatal outcome. She is normotensive to date. LEARNING POINTS: Primary aldosteronism is the most common etiology of secondary hypertension with an estimated prevalence of 5–10% in the hypertensive population. It is important to recognize the subtypes of primary aldosteronism given that certain forms can be treated surgically. Hypertension in pregnancy is associated with significantly higher maternal and fetal complications. Data regarding the treatment of primary aldosteronism in pregnancy are limited. Adrenalectomy can be considered during the second trimester of pregnancy if medical therapy fails to adequately control hypertension from primary aldosteronism. Bioscientifica Ltd 2020-08-04 /pmc/articles/PMC7424322/ /pubmed/32755966 http://dx.doi.org/10.1530/EDM-20-0043 Text en © 2020 The authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. (http://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Unique/Unexpected Symptoms or Presentations of a Disease
Shekhar, Skand
Haykal, Rasha
Kamilaris, Crystal
Stratakis, Constantine A
Hannah-Shmouni, Fady
Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
title Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
title_full Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
title_fullStr Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
title_full_unstemmed Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
title_short Curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
title_sort curative resection of an aldosteronoma causing primary aldosteronism in the second trimester of pregnancy
topic Unique/Unexpected Symptoms or Presentations of a Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424322/
https://www.ncbi.nlm.nih.gov/pubmed/32755966
http://dx.doi.org/10.1530/EDM-20-0043
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