Hypertensive crisis due to secondary aldosteronism from polyarteritis nodosa

BMJ Case Reports 2026

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Authors: Yongkang Liu, Joanna Y. Gong, Lochlan Michael Sydenham-Clarke, Cherie Ying Chiang, Alberta Yik-Bun Hoi
DOI: 10.1136/bcr-2025-269055
Cited by: 0
References: 19

Abstract

Primary aldosteronism is common in those diagnosed with hypertension and distinguishing primary aldosteronism from its mimics allows tailored management. A woman in her 30s presented to an Australian hospital with hypertensive crisis (209/100 mm Hg) and spontaneous hypokalaemia (2.9 mmol/L). Laboratory tests revealed hyperreninaemic hyperaldosteronism with a normal aldosterone-renin ratio. CT imaging showed focal areas of soft tissue encasement and enhancement surrounding multiple arteries, including the left renal artery, raising suspicion of a medium-vessel vasculitis. Further investigation led to a final diagnosis of polyarteritis nodosa with secondary aldosteronism.

Fields of Study & Subjects

Hormonal Regulation and Hypertension Vasculitis and related conditions Renal and Vascular Pathologies

Publication details

Journal / source
BMJ Case Reports
Volume
19
Issue
1
Pages
e269055–e269055
Publication date
1 January 2026
Language
EN