Abstract
Plasma aldosterone, 18-OH-DOC and Cortisol concentrations in both adrenal veins were determined simultaneously in 21 hypertensive patients with suppressed plasma renin. In aldosterone producing adenoma group plasma aldosterone was 5.2 and 18-OH-DOC 3.6 times higher on the side of adenoma. In idiopathic hyperaldosteronism with bilateral adrenal hyperplasia the concentration of aldosterone and 18-OH-DOC was symmetrically high on both sides. In low-renin essential hypertension plasma 18-OH-DOC was high, aldosterone, however, was low in both adrenal venous effluent. Plasma concentration of cortisol in adrenal veins did not differ in these 3 groups. In Cushing's syndrome cortisol was high especially in the vein from the adrenal bearing an adenoma, aldosterone was low on both sides and 18-OH-DOC showed a wide scatter. Administration of synthetic ACTH increased aldosterone and 18-OH-DOC in a patient with aldosterone producing adenoma and in 2 patients with low-renin essential hypertension. Long-term treatment with Spironolactone lowered the adrenal venous plasma aldosterone. These results suggest that simultaneous determination of aldosterone, 18-OH-DOC and cortisol in adrenal veins is helpful in the differentiation of low-renin hypertensions and in localization of an adrenocortical adenoma. Changes of aldosterone and 18-OH-DOC in adrenal plasma after ACTH and Spironolactone demonstrate the ACTH dependence of aldosterone and 18-OH-DOC and the inhibiting effect of Spironolactone on aldosterone production. These changes are due to the direct influence of adrenal steroidogenesis and not only to changes in peripheral steroid metabolism.
Key words
Aldosterone - 18-Hydroxy-Deoxycorticosterone - Cortisol-Adrenal Vein Concentration - Low-Renin Hypertensions - ACTH Stimulation - Spironolactone
1 In an abbreviated form presented at the Vth International Congress of Endocrinology, July 18-24, 176, Hamburg
