Spontaneous remission of idiopathic aldosteronism after long-term treatment with spironolactone: results from the German Conn's Registry.

Evelyn Fischer, Felix Beuschlein, Christoph Degenhart, Philip Jung, Martin Bidlingmaier, Martin Reincke

Medizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.

Clinical endocrinology 2012 Apr

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Primary aldosteronism (PA) is mainly caused by aldosterone-producing adenoma and idiopathic bilateral adrenal hyperplasia (IHA). Recently, spontaneous resolution of IHA has been described. We aimed to determine the frequency of spontaneous remission of PA during long-term treatment with mineralocorticoid receptor (MR) antagonists. Thirty-seven patients of the Munich PA registry with IHA treated by MR antagonists were investigated. The patients were identified retrospectively by chart review and prospectively assessed by clinical and biochemical means. Complete remission of IHA was defined as normal aldosterone to renin ratio (ARR), normal suppression test and normalization of hypokalaemia in the presence of normal blood pressure. Partial remission was defined as normalization of normal ARR, normal suppression test and normalization of hypokalaemia in the presence of persistent hypertension. The mean period of MR antagonist treatment was 5·8 ± 0·7 years in the patients. We identified two of 37 (5·4%) patients with spontaneous remission: one with complete remission and one with partial remission. Remission of IHA in PA may occur in some patients after long-term mineralocorticoid antagonist treatment. © 2012 Blackwell Publishing Ltd.

Citation

Evelyn Fischer, Felix Beuschlein, Christoph Degenhart, Philip Jung, Martin Bidlingmaier, Martin Reincke. Spontaneous remission of idiopathic aldosteronism after long-term treatment with spironolactone: results from the German Conn's Registry. Clinical endocrinology. 2012 Apr;76(4):473-7