SHM Converge Scientific Abstract ePoster Gallery-A Pheo-Nomenal Case of Aldosteronoma

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This case report describes a 37-year-old postpartum woman with persistent hypertension, hypokalemia, metabolic alkalosis, and pre-eclampsia history, who presented four months after delivery with headache, weakness, and severe blood pressure elevation. Her workup showed an elevated aldosterone-to-renin ratio, suggesting primary hyperaldosteronism. Imaging identified both a left adrenal mass and an extra-adrenal retroperitoneal mass, initially thought to be pheochromocytomas. Although some catecholamine tests were negative, 24-hour normetanephrine was elevated. Surgical pathology ultimately revealed two different endocrine tumors: an adrenal aldosteronoma and an extra-adrenal pheochromocytoma.<br /><br />The discussion emphasizes that secondary causes of hypertension in pregnancy are uncommon but important, because they can significantly worsen maternal outcomes. The patient’s combination of resistant hypertension, hypokalemia, and metabolic alkalosis strongly supported primary aldosteronism. The report also notes that adrenal incidentalomas are usually nonfunctional, while pheochromocytomas and especially aldosteronomas are much less common.<br /><br />The authors conclude that it is unclear whether the tumors existed before pregnancy, but clinicians should consider endocrine causes in pregnant or postpartum patients with hypertension, especially when findings are atypical or do not fully fit standard pre-eclampsia. Recognizing secondary hypertension early may improve diagnosis, treatment, and outcomes.

Asset Subtitle

Kaitlyn Luckock

Meta Tag

Author List Caitlin C. Lee, Kaitlyn Luckock, Kelly A. Le

Category Clinical Vignettes

Concept Secondary Hypertension

Concept Primary Hyperaldosteronism

Concept Pheochromocytoma

Concept Aldosterone-to-Renin Ratio

Concept Pregnancy

Distinguished Non-Finalist

Presenter Organization Naval Hospital Jacksonville

Presenting Author Kaitlyn Luckock

Track Adult

Keywords

postpartum hypertension

primary hyperaldosteronism

aldosteronoma

pheochromocytoma

hypokalemia

metabolic alkalosis

pre-eclampsia

adrenal mass

secondary hypertension

normetanephrine

Secondary Hypertension

Primary Hyperaldosteronism

Pheochromocytoma

Aldosterone-to-Renin Ratio

Pregnancy