{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T06:27:05Z","timestamp":1740119225038,"version":"3.37.3"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T00:00:00Z","timestamp":1564358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>New onset resistant hypertension in a previously stable patient with chronic hypertension should lead to consideration of secondary causes. Electrolyte abnormalities are useful clues for identifying some common causes, especially mineralocorticoid excess.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CASE PRESENTATION<\/jats:title>\n                  <jats:p>We report the case of a 69-year-old man who developed severe resistant hypertension despite the use of 6 antihypertensive medications, including diuretics. He had metabolic alkalosis and hypokalemia with suppressed plasma renin activity and serum aldosterone. Concurrently, he was diagnosed with small cell neuroendocrine carcinoma of the prostate gland, a rare form of prostate cancer. Despite absence of typical Cushingoid features, investigation confirmed the diagnosis of ectopic adrenocorticotropic hormone (ACTH) syndrome from neuroendocrine prostate cancer. Because of the severity of his hypercortisolism, he underwent urgent bilateral adrenalectomy for hormonal and symptomatic control. Blood pressure improved significantly and he was dismissed with a single antihypertensive agent. Unfortunately, the patient died from his cancer 1 month later.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>Primary and secondary hyperaldosteronism are usually diagnosed based on measurements of aldosterone and plasma renin activity. However, if plasma renin activity and aldosterone are both low, rare causes of mineralocorticoid excess such as ectopic ACTH syndrome should be entertained.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpz125","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T04:38:31Z","timestamp":1564115911000},"page":"1214-1217","source":"Crossref","is-referenced-by-count":4,"title":["New-Onset Resistant Hypertension in a Newly Diagnosed Prostate Cancer Patient"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7648-2523","authenticated-orcid":false,"given":"Nattawat","family":"Klomjit","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J","family":"Rowan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea G","family":"Kattah","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Mayo Clinic , Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra J","family":"Taler","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,29]]},"reference":[{"key":"2022101210460576100_CIT0001","article-title":"Global prevalence of resistant hypertension: a meta-analysis of data from 3.2 million patients","author":"Noubiap","year":"2018","journal-title":"Heart (Br Card Soc)"},{"key":"2022101210460576100_CIT0002","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J Hypertens"},{"key":"2022101210460576100_CIT0003","first-page":"e426","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"138","author":"Whelton","year":"2018","journal-title":"Circulation"},{"key":"2022101210460576100_CIT0004","doi-asserted-by":"crossref","first-page":"R80","DOI":"10.1530\/EC-17-0081","article-title":"Severe Cushing\u2019s syndrome due to small cell prostate carcinoma: a case and review of literature","volume":"6","author":"Elston","year":"2017","journal-title":"Endocr Connect"},{"key":"2022101210460576100_CIT0005","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1097\/01.hjh.0000431740.32696.cc","article-title":"2013 ESH\/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)","volume":"31","author":"Mancia","year":"2013","journal-title":"J Hypertens"},{"key":"2022101210460576100_CIT0006","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1001\/archinte.1987.00370070103015","article-title":"Secondary hypertension in a blood pressure clinic","volume":"147","author":"Sinclair","year":"1987","journal-title":"Arch Intern Med"},{"key":"2022101210460576100_CIT0007","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1097\/00004872-199405000-00015","article-title":"The effect of age on prevalence of secondary forms of hypertension in 4429 consecutively referred patients","volume":"12","author":"Anderson","year":"1994","journal-title":"J Hypertens"},{"key":"2022101210460576100_CIT0008","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ecl.2018.01.005","article-title":"The ectopic adrenocorticotropic hormone syndrome: rarely easy, always challenging","volume":"47","author":"Hayes","year":"2018","journal-title":"Endocrinol Metab Clin North Am"},{"key":"2022101210460576100_CIT0009","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s11102-018-0894-2","article-title":"Two types of ectopic Cushing syndrome or a continuum? 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