Dexamethasone suppressible hyperaldosteronism in a child with nephrosclerosis

S. M. Lee, E. Lightner, M. Witte, S. Oberfield, L. Levine, M. I. New

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

A 9 year old Mexican boy presented with severe hypertension, hypokalaemia and features suggesting acute glomerulonephritis. Nephrosclerosis was present on renal biopsy. Aldosterone levels were unresponsive to variations in dietary salt intake and plasma renin activity was suppressed. Following oral dexamethasone therapy (2 mg/day), plasma aldosterone decreased to undetectable levels, serum potassium normalized and plasma renin activity gradually increased. Dexamethasone also restored the normal responsiveness of the renin-aldosterone system to postural stimuli. The patient exhibited a marked response to a single dose of ACTH with a rise in plasma aldosterone. Long-term blood pressure control and normal potassium levels have been achieved with oral prednisone therapy (5 mg/day) for a period of one year. This case of dexamethasone suppressible hyperaldosteronism (DSH) illustrates that the degree of hypertension in this syndrome may produce severe renal microvascular lesions. DSH should be considered in all children who present with low renin hypertension.

Original languageEnglish (US)
Pages (from-to)251-255
Number of pages5
JournalUnknown Journal
Volume99
Issue number2
DOIs
StatePublished - 1982

ASJC Scopus subject areas

  • Endocrinology

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