Abiraterone-Induced Secondary Hypertension: Two Wrongs Don’t Make a Right

TL;DR

Abiraterone, a prostate cancer drug, can cause severe hypertension and other issues even with prednisolone use.

Contribution

Reports a case of abiraterone-induced mineralocorticoid excess despite prednisolone.

Findings

Abiraterone caused secondary hypertension and hypokalemia.

Metabolic alkalosis and elevated ACTH levels were observed.

Prednisolone failed to prevent the mineralocorticoid excess.

Abstract

Abiraterone, an inhibitor of both 17α-hydroxylase and 17,20-lyase, is considered a novel, state-of-the-art, life-prolonging therapy in the urologists’ arsenal when treating prostate cancer. Despite its efficacy, it is linked with an increased risk of cardiovascular adverse effects. Herein, we report a case in which the administration of abiraterone resulted in a full-blown syndrome of apparent mineralocorticoid excess despite the concomitant administration of prednisolone; that is, secondary hypertension, hypokalemia, metabolic alkalosis, as well as elevated levels of adrenocorticotropic hormone (ACTH).

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