[Primary aldosteronism]

Détails

ID Serval
serval:BIB_25CD7CFD5F7C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
[Primary aldosteronism]
Périodique
Schweizerische Medizinische Wochenschrift
Auteur⸱e⸱s
Vetter  W., Vetter  H., Nussberger  J., Witassek  F., Beckerhoff  R., Pouliadis  G., Braun  K. P., Sobbe  A., Furrer  J., Siegenthaler  W.
ISSN
0036-7672 (Print)
Statut éditorial
Publié
Date de publication
04/1976
Volume
106
Numéro
14
Pages
469-74
Notes
English Abstract
Journal Article --- Old month value: Apr 3
Résumé
The syndrome of primary aldosteronism is caused either by an aldosterone-producing adenoma or by idiopathic bilateral adrenal hyperplasia. Hypokalemic hypertension is the leading symptome of the disease. Diagnosis is by the combination of abnormally high and non-suppressible aldosterone values with undetectable or low renin values unresponsive to postural changes or salt restriction. Patients with aldosterone-producing adenoma normally show a fall in plasma aldosterone in response to posture and ACTH-dependent circadian rhythm of aldosterone, whereas bilateral hyperplasia is characterized by postural increases in plasma aldosterone and an ACTH-independent diurnal aldosterone rhythm. These creteria serve to differentiate between adenoma and hyperplasia. An aldosterone-producing adenoma can be localized by veinography, determination of aldosterone concentration in both adrenal veins and by 131I-cholesterol scintigraphy. In our hands the determination of aldosterone in blood from both adrenal veins is the most efficient procedure. In interpreting the results, however, rhythmic and sudden changes in adrenal hormone secretion should be considered. In cases where no adrenal venous blood is obtained, 131I-cholesterol scintigraphy may be used to localize adenoma. In patients with aldosterone-producing adenomas unilateral adrenalectomy should be performed, whereas patients with idiopathic bilateral hyperplasia should receive antihypertensive therapy. As rare instances of primary aldosteronism, a case of aldosterone-producing carcinoma of the adrenal cortex and a case of presumably unilateral adrenal hyperplasia are reported.
Mots-clé
Adenoma/complications Adrenal Cortex Neoplasms/complications Adrenalectomy Adrenocortical Hyperfunction/complications Aldosterone/analysis Antihypertensive Agents/therapeutic use Circadian Rhythm Humans *Hyperaldosteronism Hyperkalemia/etiology Hypertension/etiology Posture Renin/analysis
Pubmed
Web of science
Création de la notice
05/03/2008 17:40
Dernière modification de la notice
20/08/2019 14:04
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