PMC8608520_01
Thrombotic microangiopathy evolution. MTH-EAR: months earlier; Disch: discharge; MTH-FW: months follow-up; Hb: hemoglobin; Ptl: platelets; LDH: lactate desidrogenase; Creat: creatinine. Analytical values presented as hemoglobin in g/dL, platelets in 104/uL, LDH in 102 U/L, and creatinine in mg/dL.
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Over the first ten days after admission, she presented severe anaemia requiring multiple red blood cell transfusions, platelet downward trend, and high LDH levels (Figure 1).
Blood pressure evolution. MTH-EAR: months earlier; Disch: discharge; MTH-FW: months follow-up; SBP: systolic blood pressure; DBP: diastolic blood pressure. Blood pressure values presented as mmHg.
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The only abnormal finding on physical examination during hospital-stay, besides excessive weight (body mass index of 34.7 kg/m2), was grade 3 hypertension (Figure 2), even under five classes of antihypertensive drugs (previous mentioned plus minoxidil). We observed improved control of hypertension (Figure 2) and suspension of potassium supplementation. In the postoperative period, she evolved with controlled hypertension under only three antihypertensive drugs (carvedilol, nifedipine, and clonidine) (Figure 2) and no additional need for potassium supplements.
CT scan. Axial and coronal planes of CT scan showing left adrenal mass (indicated by red arrow).
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MRI was suggestive of a cortical adenoma, and blood analysis was compatible with hyperaldosteronism (Figure 3).