Spontaneous remission of idiopathic aldosteronism

Primary aldosteronism (PA) has been recognised as the most frequent cause of secondary arterial hypertension. The main causes are aldosterone-producing adenoma and idiopathic bilateral adrenal hyperplasia (IHA). The cure rate after unilateral or bilateral adrenalectomy in IHA is only 19%. Therefore, this subtype of PA is usually treated by lifetime administration of mineralocorticoid receptor (MR) antagonists.

Fischer et al. evaluated in a cohort of 37 patients with PA whether remission of IHA occurred during follow-up after prolonged treatment with MR antagonists. The mean period of MR antagonist treatment was 5.8 ± 0.7 years in the patients. They identified two of 37 (5.4%) patients with spontaneous remission: one with complete remission and one with partial remission. They concluded that remission of IHA in PA may occur in some patients after long-term mineralocorticoid antagonist treatment. Fischer et al. (2012) Clinical Endocrinology, 76 473-477.

Read the full article at DOI: 10.1111/j.1365-2265.2011.04243.x