Surgical Outcomes Among Primary Aldosteronism Patients Without Visible Adrenal Lesions.

Autor:	Sam D; Department of Medicine, University of Calgary, Calgary, Alberta, Canada., Kline GA; Department of Medicine, University of Calgary, Calgary, Alberta, Canada., So B; Department of Radiology, University of Calgary, Calgary, Alberta, Canada., Pasieka JL; Department of Surgery, University of Calgary, Calgary, Alberta, Canada., Harvey A; Department of Surgery, University of Calgary, Calgary, Alberta, Canada., Chin A; Alberta Precision Laboratories, Alberta Health Services, Calgary, Alberta, Canada.; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada., Przybojewski SJ; Department of Radiology, University of Calgary, Calgary, Alberta, Canada., Leung AA; Department of Medicine, University of Calgary, Calgary, Alberta, Canada.; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2021 Jan 23; Vol. 106 (2), pp. e824-e835.
DOI:	10.1210/clinem/dgaa821
Abstrakt:	Context: Many patients with unilateral primary aldosteronism (PA) have normal adrenal imaging, but little is known about their outcome following adrenalectomy. Objective: To evaluate biochemical and clinical outcomes after adrenalectomy in patients with unilateral PA and normal-appearing adrenal imaging. Design: Retrospective cohort study of patients seen between January 2006 and May 2018. Setting: A Canadian tertiary care PA referral center. Patients: Consecutive individuals with PA, normal cross-sectional adrenal imaging, and lateralizing adrenal vein sampling (AVS) who underwent adrenalectomy during the study period. Primary Outcome: Biochemical response to adrenalectomy graded according to the Primary Aldosteronism Surgical Outcome criteria. Results: A total of 40 patients were included. Biochemical outcomes were available for 33 people (mean age, 54.7 years; 91% male; median follow-up, 2.7 months), with 28 (85%) showing a complete or partial response and 5 (15%) with no response. Clinical outcomes were available for 36 people (mean age, 54.6 years; 86% male; median follow-up, 9.8 months), with 31 (86%) demonstrating a complete or partial response and 5 (14%) with no response. Conclusions: The prognosis after adrenalectomy is highly favorable for patients with unilateral PA and normal-appearing adrenal imaging. Patients with lateralizing disease should be considered for surgery despite apparently normal adrenal imaging. (© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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