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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
1   Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy
,
S. Monticone
1   Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy
,
M. Tetti
1   Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy
,
D. Rossato
2   Division of Radiology, University of Torino, Torino, Italy
,
K. Versace
2   Division of Radiology, University of Torino, Torino, Italy
,
I. Castellano
3   Division of Pathology, Department of Medical Sciences, University of Torino, Torino, Italy
,
T. A. Williams
1   Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy
4   Medizinische Klinik und Poliklinik IV (T.A.W.), Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
,
F. Veglio
1   Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy
,
P. Mulatero
1   Division of Internal Medicine and Hypertension, University of Torino, Torino, Italy
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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


Publication History

Received: 15 August 2015

Accepted: 07 October 2015

Article published online:
17 November 2015

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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