Making an unexpected diagnosis of a rare disorder

Glucocorticoid-remediable aldosteronism (GRA) is a rarely recognized form of primary aldosteronism in which aldosterone secretion is solely under the control of adrenocorticotropic hormone (ACTH). It is often characterized by moderate to severe arterial hypertension occurring early in life, volume expansion, variable levels of hyperaldosteronism, very low plasma renin activity and hypokalemia. We report a case of a young man in whom the diagnosis of GRA was suspected after the observation of hypotension while using topical steroids.