Primary hyperaldosteronism: difficulties in diagnosis
Primary hyperaldosteronism (PA) - is the clinical syndrome, results from autonomous of the major regulators of secretion, aldosterone overproduction by a tumorous or hyperplastic tissue in adrenal cortex. Being the most frequent cause of secondary hypertension, PA may be represented by disorders wit...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | Russian |
Published: |
"Consilium Medicum" Publishing house
2019-10-01
|
Series: | Терапевтический архив |
Subjects: | |
Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/33707/pdf |
id |
doaj-e6c88c1df6ed48148f4407f645244772 |
---|---|
record_format |
Article |
spelling |
doaj-e6c88c1df6ed48148f4407f6452447722020-11-25T02:58:06Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422019-10-019110919910.26442/00403660.2019.10.00013830435Primary hyperaldosteronism: difficulties in diagnosisB M Shifman0N M Platonova1N V Molashenko2E A Troshina3I I Sitkin4D G Belcevich5L D Kovalevich6N Yu Romanova7G S Kolesnikova8Endocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentrePrimary hyperaldosteronism (PA) - is the clinical syndrome, results from autonomous of the major regulators of secretion, aldosterone overproduction by a tumorous or hyperplastic tissue in adrenal cortex. Being the most frequent cause of secondary hypertension, PA may be represented by disorders with unilateral or bilateral aldosterone overproduction and differential diagnosis between them is crucial for choosing a right therapeutic approache: lifelong medical therapy with mineralocorticoid receptor antagonists or unilateral adrenalectomy. Adrenal venous sampling (AVS) is currently the «gold standard» test for identifying laterality of excess hormone production, unlike imaging tests, sensitivity and specificity of which is not enough, due to inability to evaluate functional activity with confidence, and also to limitations in detecting tiny abnormalities of adrenals, such as microadenoma or hyperplasia. Excluding certain cases, AVS is recommended to patients with confirmed PA, planning surgical treatment, to determine the lateralization of aldosterone hypersecretion. Described clinical case of patient with confirmed lateralization from adrenal without any detected lesions on CT-imaging and nonfunctioning tumour on contralateral side, highlights the importance of using AVS for decision to refer patients for surgery.https://ter-arkhiv.ru/0040-3660/article/viewFile/33707/pdfaldosteroneprimary aldosteronismadrenal venous samplingconn's diseasebilateral adrenal hyperplasiacase report |
collection |
DOAJ |
language |
Russian |
format |
Article |
sources |
DOAJ |
author |
B M Shifman N M Platonova N V Molashenko E A Troshina I I Sitkin D G Belcevich L D Kovalevich N Yu Romanova G S Kolesnikova |
spellingShingle |
B M Shifman N M Platonova N V Molashenko E A Troshina I I Sitkin D G Belcevich L D Kovalevich N Yu Romanova G S Kolesnikova Primary hyperaldosteronism: difficulties in diagnosis Терапевтический архив aldosterone primary aldosteronism adrenal venous sampling conn's disease bilateral adrenal hyperplasia case report |
author_facet |
B M Shifman N M Platonova N V Molashenko E A Troshina I I Sitkin D G Belcevich L D Kovalevich N Yu Romanova G S Kolesnikova |
author_sort |
B M Shifman |
title |
Primary hyperaldosteronism: difficulties in diagnosis |
title_short |
Primary hyperaldosteronism: difficulties in diagnosis |
title_full |
Primary hyperaldosteronism: difficulties in diagnosis |
title_fullStr |
Primary hyperaldosteronism: difficulties in diagnosis |
title_full_unstemmed |
Primary hyperaldosteronism: difficulties in diagnosis |
title_sort |
primary hyperaldosteronism: difficulties in diagnosis |
publisher |
"Consilium Medicum" Publishing house |
series |
Терапевтический архив |
issn |
0040-3660 2309-5342 |
publishDate |
2019-10-01 |
description |
Primary hyperaldosteronism (PA) - is the clinical syndrome, results from autonomous of the major regulators of secretion, aldosterone overproduction by a tumorous or hyperplastic tissue in adrenal cortex. Being the most frequent cause of secondary hypertension, PA may be represented by disorders with unilateral or bilateral aldosterone overproduction and differential diagnosis between them is crucial for choosing a right therapeutic approache: lifelong medical therapy with mineralocorticoid receptor antagonists or unilateral adrenalectomy. Adrenal venous sampling (AVS) is currently the «gold standard» test for identifying laterality of excess hormone production, unlike imaging tests, sensitivity and specificity of which is not enough, due to inability to evaluate functional activity with confidence, and also to limitations in detecting tiny abnormalities of adrenals, such as microadenoma or hyperplasia. Excluding certain cases, AVS is recommended to patients with confirmed PA, planning surgical treatment, to determine the lateralization of aldosterone hypersecretion. Described clinical case of patient with confirmed lateralization from adrenal without any detected lesions on CT-imaging and nonfunctioning tumour on contralateral side, highlights the importance of using AVS for decision to refer patients for surgery. |
topic |
aldosterone primary aldosteronism adrenal venous sampling conn's disease bilateral adrenal hyperplasia case report |
url |
https://ter-arkhiv.ru/0040-3660/article/viewFile/33707/pdf |
work_keys_str_mv |
AT bmshifman primaryhyperaldosteronismdifficultiesindiagnosis AT nmplatonova primaryhyperaldosteronismdifficultiesindiagnosis AT nvmolashenko primaryhyperaldosteronismdifficultiesindiagnosis AT eatroshina primaryhyperaldosteronismdifficultiesindiagnosis AT iisitkin primaryhyperaldosteronismdifficultiesindiagnosis AT dgbelcevich primaryhyperaldosteronismdifficultiesindiagnosis AT ldkovalevich primaryhyperaldosteronismdifficultiesindiagnosis AT nyuromanova primaryhyperaldosteronismdifficultiesindiagnosis AT gskolesnikova primaryhyperaldosteronismdifficultiesindiagnosis |
_version_ |
1724708511467700224 |