A short review of primary aldosteronism in a question and answer fashion
| Autor: | Evangelos P. Misiakos, Dimitrios Sotiropoulos, Georgios Martikos, Frederick-Anthony Farrugia, Nikolaos Koliakos, Anestis Charalampopoulos, Panagiotis Tzanetis, Nicolaos Zavras |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
diagnosis Endocrinology Diabetes and Metabolism medicine.medical_treatment idiopathic adrenal hyperplasia Urology Secondary hypertension 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Plasma renin activity Diseases of the endocrine glands. Clinical endocrinology surgery 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology Primary aldosteronism Mineralocorticoid receptor Hyperaldosteronism medicine Humans Aldosterone primary aldosteronism treatment business.industry Adrenalectomy aldosterone producing adenoma medicine.disease RC648-665 radiology chemistry Spironolactone business |
| Zdroj: | Endocrine Regulations, Vol 52, Iss 1, Pp 27-40 (2018) |
| ISSN: | 1210-0668 |
| Popis: | Objectives. The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. Methods. We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery. We also did cross-referencing search with the above terms. We had divided our study into five sections: Introduction, Diagnosis, Genetics, Treatment, and Conclusions. We present our results in a question and answer fashion in order to make reading more interesting. Results. PA should be searched in all high-risk populations. The gold standard for diagnosis PA is the plasma aldosterone/plasma renin ratio (ARR). If this test is positive, then we proceed with one of the four confirmatory tests. If positive, then we proceed with a localizing technique like adrenal vein sampling (AVS) and CT scan. If the lesion is unilateral, after proper preoperative preparation, we proceed, in adrenalectomy. If the lesion is bilateral or the patient refuses or is not fit for surgery, we treat them with mineralocorticoid receptor antagonists, usually spironolactone. Conclusions. Primary aldosteronism is the most common and a treatable case of secondary hypertension. Only patients with unilateral adrenal diseases are eligible for surgery, while patients with bilateral and non-surgically correctable PA are usually treated by mineralocorticoid receptor antagonist (MRA). Thus, the distinction between unilateral and bilateral aldosterone hypersecretion is crucial. |
| Databáze: | OpenAIRE |
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