Plasma Concentration of Renin in a Patient With Conn's Syndrome With Fibrinoid Lesions of the Renal Arterioles: The Effect of Treatment With Spironolactone

SUMMARY A case is described in which the presence of an adrenal cortical adenoma was predicted from the association of hypertension, hypokalaemia, raised aldosterone secretion and depressed plasma renin concentration. Pre-operatively, administration of a spironolactone for a period of 10½ months corrected the electrolyte abnormalities, increased the plasma renin concentration to normal and lowered the blood pressure, although the raised aldosterone secretion was unchanged. At operation a typical adrenal cortical adenoma was found. Renal biopsy at operation showed arteriolar fibrinoid lesions, although no retinal lesions were seen at any stage.