Aldosterone levels are undetectable - proteus

[ArchivalUser]

A 14-year-old male is found to be hypertensive. His electrolytes are significant for hypokalemia and a metabolic alkalosis. Aldosterone levels are undetectable. Which of the following would be the most appropriate treatment of this condition?

A. Dexamethasone
B. Spironolactone
C. Tetracycline
D. Amiloride
E. Furosemide

[ArchivalUser]

B-spironolactone.

[ArchivalUser]

Choice (D) is the correct answer. Liddle's syndrome is an autosomal dominant condition caused by mutations of amiloride-sensitive epithelial sodium channels (ENaC) which results in abnormal sodium absorption and potassium secretion in the collecting ducts of the kidneys. The triad of symptoms includes hypertension, hypokalemia, and metabolic alkalosis. Aldosterone levels are markedly low or absent in Liddle's syndrome, and the disease does not respond to spironolactone. Treatment involves amiloride or triamterene diuretics, both of which are potassium-sparing. The other choices are not used in the treatment of Liddle's syndrome.