Primary aldosteronism: A case with severe hypertension

Abstract A case of primary aldosteronism is described. The presenting features were some indefinite unsteadiness of gait, with incidental hypertension discovered on routine examination. Symptoms of polyuria, polydipsia and attacks of generalised weakness did not develop until ten months later, shortly after a thoracolumbar sympathectomy had been performed for the hypertension. After a diagnosis of primary aldosteronism had been made, balance studies were performed over a period of seven weeks preoperatively and three weeks postoperatively. The biochemical findings are discussed. At operation an aldosterone-secreting tumour was removed from the left suprarenal gland. Except for the persistence of (a less marked) hypertension the patient has remained normal for the twenty-four months since the operation.