XXXX in disguise--a trap for the unwary.

@entity1 @entity8 @entity1369 @entity101 @entity8767 @entity972 @entity652 @entity1368 @entity1371
A 36-year-old asymptomatic Chinese male with @entity8 ( @entity8 ) developed @entity101 1 year after the diagnosis of @entity8 . The @entity1 was treated initially as for @entity101 associated with @entity8 . However, over a 6-year period his @entity101 became progressively difficult to control and he developed severe symptomatic @entity1371 . Subsequent investigations confirmed the presence of primary @entity1368 . The initial computed tomographic scans of the adrenals did not reveal any definite @entity652 . The @entity1 subsequently underwent bilateral adrenal venous sampling, which suggested a left-sided source of @entity1369 excess. A repeat computed tomography of the adrenals with fine cuts revealed a 6-mm diameter adenoma of the left adrenal gland. He underwent an uncomplicated left adrenalectomy. All antihypertensive and @entity972 supplements were stopped on the 5th postoperative day. Two and half years after the adrenalectomy he remains normotensive and normokalaemic without any medication. The case illustrates the importance of measuring serum @entity972 before initiation of any therapy and the need to consider secondary causes even if a primary association is known. It also reinforces the fact that when @entity101 becomes difficult to control, a secondary cause has to be searched actively. The association between @entity1368 and @entity8 has been highlighted only recently. The association of @entity8767 and @entity1368 has been reported in the literature only once previously.
