Therapy with the antifungal agent posaconazole can result in pseudohyperaldosteronism.
Clinical features consistent with apparent mineralocorticoid excess:
(1) hypertension
(2) water retention with peripheral edema and/or heart failure
Laboratory features:
(1) hypokalemia
(2) low serum renin concentration
(3) low serum aldosterone concentration
(4) mild alkalosis
Mechanism: inhibition of the enzyme 11-beta-hydroxysteroid dehydrogenase 2 (related to effect of licorice metabolites), with overactivation of aldosterone receptors.
The diagnosis requires:
(1) absence of findings prior to posaconazole therapy
(2) reversal after discontinuation of the posaconazole
To read more or access our algorithms and calculators, please log in or register.
