Subtype Diagnosis of Primary Aldosteronism: Approach to Different
                    Clinical Scenarios

J. Burrello; S. Monticone; M. Tetti; D. Rossato; K. Versace; I. Castellano; T. A. Williams; F. Veglio; P. Mulatero

doi:10.1055/s-0035-1565089

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2015; 47(13): 959-966
DOI: 10.1055/s-0035-1565089

Review

Subtype Diagnosis of Primary Aldosteronism: Approach to Different Clinical Scenarios

J. Burrello

¹Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy

,

S. Monticone

¹Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy

,

M. Tetti

¹Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy

,

D. Rossato

²Division of Radiology, University of Torino, Torino, Italy

,

K. Versace

²Division of Radiology, University of Torino, Torino, Italy

,

I. Castellano

³Division of Pathology, Department of Medical Sciences, University of Torino, Torino, Italy

,

T. A. Williams

¹Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy

⁴Medizinische Klinik und Poliklinik IV (T.A.W.), Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany

,

F. Veglio

¹Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy

,

P. Mulatero

¹Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy

› Author Affiliations

Abstract

Identification and management of patients with primary aldosteronism are of utmost importance because it is a frequent cause of endocrine hypertension, and affected patients display an increase of cardio- and cerebro-vascular events, compared to essential hypertensives. Distinction of primary aldosteronism subtypes is of particular relevance to allocate the patients to the appropriate treatment, represented by mineralocorticoid receptor antagonists for bilateral forms and unilateral adrenalectomy for patients with unilateral aldosterone secretion. Subtype differentiation of confirmed hyperaldosteronism comprises adrenal CT scanning and adrenal venous sampling. In this review, we will discuss different clinical scenarios where execution, interpretation of adrenal vein sampling and subsequent patient management might be challenging, providing the clinician with useful information to help the interpretation of controversial procedures.

Key words

primary aldosteronism - adrenal vein sampling - aldosterone-producing adenoma - bilateral adrenal hyperplasia

Full Text

References

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