Bilateral aldosterone-producing adenomas: differentiation from bilateral adrenal hyperplasia

摘要: Background: Primary aldosteronism (PA) is a common curable disease of secondary hypertension. Most such patients have either idiopathic bilateral adrenal hyperplasia (BAH) or unilateral aldosterone-producing adenoma (APA). Bilateral APAs are reportedly extremely rare. Aim: To compare the distinctive characteristics, clinical course, and outcomes APA vs. BAH. Design: Retrospective record review. Methods: From July 1994 to Jan 2007, 190 diagnosed with PA underwent surgical intervention at our hospital. was in 7/164 histologically-proven APA. Twenty-one as BAH, 21 randomly selected patients, matched by age sex served controls. Results: Patients had similar blood pressure, arterial gas analysis, spot urinary potassium creatinine ratio symptoms those but lower serum levels ( p = 0.027), plasma renin activity 0.037), higher aldosterone concentrations 0.029). Aldosterone-renin (ARR) after administration 50 mg captopril than BAH 0.023), not different between 0.218). A cut-off ARR >100 ng/dl per ng/ml/h >20 significantly differentiated from BAH. subtotal adrenalectomy normalized pressure biochemistry all APA. Discussion: APA, presenting simultaneously sequentially, may be rare disease, accounting for 4.3% this sample. The presentations functional low should carefully evaluated adenoma.