Primary Aldosteronism

Grant, Clive S.

doi:10.1001/archsurg.1984.01390170081016

Cited by 39 publications

(2 citation statements)

References 30 publications

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“…The serum K usually normalizes immediately after surgery. Hypertension is cured in 60-80% of patients with APA, and the rest achieve some improvement of hypertension postoperatively [8][9][10]. It is also true that some patients cannot acquire normal blood pressure after surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of associated nodular lesions of the adrenal in patients with aldosteronoma

et al. 1990

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Thirty-seven patients with primary aldosteronism were treated by unilateral total adrenalectomy during a 7-year period (1981-1987). The 37 patients were classified into 3 groups on the basis of adrenal pathology: unilateral solitary adenoma, 23 cases (group 1); unilateral adenomas, 3 cases (group 2); and adenoma with multiple macro- or microscopic nodules, 11 cases (group 3). The preoperative conditions of the patients (age, duration of hypertension, plasma renin activity, plasma aldosterone concentration, and serum potassium concentration), postoperative sequential changes of hormone levels, and outcome of hypertension were compared among the groups in order to determine whether the differences of adrenal pathology would affect the postoperative course. The preoperative parameters excluding age at surgery did not differ significantly among the 3 groups. The mean age in group 3, however, was slightly higher than in groups 1 and 2 (47.8 versus 42.8 versus 42.7 years). Postoperative hormonal changes were also similar, particularly in groups 1 and 3, staying within the normal range throughout the follow-up period (mean, 31 months; range, 3-86 months). However, postoperative improvement of hypertension showed marked differences, being significantly retarded in patients with multinodular lesions (group 3), about half of whom remained hypertensive even after 1 year. Nodular lesions other than adenoma(s) were, therefore, thought not to contribute to hormonal excess but to result from intractable hypertension.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of associated nodular lesions of the adrenal in patients with aldosteronoma

et al. 1990

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“…3 The first case of primary aldosteronism was described by Conn in 1955. 4 Primary aldosteronism has two main causes, namely aldosterone-producing adenoma (APA, also known as Conn's syndrome) and bilateral adrenal hyperplasia (BAH). 1,2,5 It is important to differentiate the two since Conn's syndrome is generally managed by unilateral adrenalectomy which is potentially curative, while BAH is managed medically.…”

Section: Introductionmentioning

confidence: 99%

Use of NP-59 (131I-iodocholesterol) Scan as a Potential Alternative to Adrenal Venous Sampling in the Investigation of Primary Aldosteronism: a 5-Year Retrospective Study

Chan¹,

Cheng²

2014

Hong Kong J Radiol

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Objectives: To evaluate the usefulness of NP-59 (131 I-iodocholesterol) scan as a non-invasive alternative to adrenal venous sampling in the diagnosis of Conn's syndrome and lateralisation of aldosterone production. Methods: The electronic patient records of 39 consecutive patients who were referred for NP-59 scan in our centre between 1 January 2007 and 31 December 2012 were reviewed. The results of NP-59 scan, biochemical test, subsequent treatment plan, histopathology findings, and clinical outcome were evaluated. Results: Of the 39 patients, 17 had successful lateralisation of aldosterone production by NP-59 scan. Of these 17 patients, 11 had unilateral adrenalectomy, six patients refused surgery. Unilateral adrenalectomy treatment success was reported in all 11 (100%) patients who had lateralisation of aldosterone source by NP-59 scan. Conclusion: Our study has shown that NP-59 scan as a single imaging investigation has excellent positive predictive value in the diagnosis of aldosterone-producing adenoma (Conn's syndrome) and NP-59 scan can be used as an alternative to adrenal venous sampling.

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