METABOLIC OBSERVATIONS IN A CASE OF PURE PRIMARY HYPERALDOSTERONISM

Abstract

Steroidal and metabolic studies were carried out in a typical case of pure primary hyperaldosteronism. Analysis of the urine for known steroids failed to show significant abnormalities other than hyperaldosteronuria and a low excretion of 5α-pregnane-3β, 16α-diol-20-one (sodium-excreting factor). ACTH stimulated the production of corticosteroids, including aldosterone, and 9α-fluoro-Δ¹-cortisol inhibited production. Extract of the posterior hypophysis caused an increase in aldosterone excretion without altering that of other steroids. The effect of sodium excess on aldosterone was studied. The data indicate that production of aldosterone in this case was not independent of controlling hormonal and humoral factors. Metabolic studies demonstrated, 1) an approximate parallelism between sodium and potassium balances, 2) rapid natriuresis of a sodium load, and 3) lack of correlation between aldosteronuria and sodium balance. The physiopathologic implications of these facts are discussed.