Correct Answer
Your Answer: Unilateral adrenalectomy
Unilateral adrenalectomy is the treatment of choice in a young patient (younger than 50 years) with primary hyperaldosteronism, who has lateralization of aldosterone secretion, determined by adrenal vein sampling.
This patient’s adrenal vein aldosterone secretion was lateralized to the left side. She underwent left adrenalectomy with histopathology showing a 1.3 cm adrenal adenoma. Subsequently, the patient has been normotensive on no medication, with no further incidence of hypokalemia and normalization of all biochemical values.
Department of Health and Human Services, National Institutes of Health, and the National Heart, Lung, and Blood Institute, USA. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Available at http://nhlbi.nih.gov/guidelines/hypertension/
Sawka AM, Young WF, Thompson GB, et al. Primary aldosteronism: factors associated with normalization of blood pressure after surgery. Ann Intern Med 2001;135:2587–61.