Experience of topographical diagnosis in primary aldosteronism
Adamson, U.; Efendic, S.; Granberg, P.; Lindvall, N.; Lins, P.; Löw, H.; Milentijevic, G.
Lakartidningen 77(45): 4145-4148
1980
ISSN/ISBN: 0023-7205 PMID: 7453387 Document Number: 156667
The efficiency of 6 different methods for topographical diagnosis in primary aldosteronism was analyzed in retrospect from 11 surgically verified cases. Differentiation between hyperplasia and adenoma was most safely achieved by monitoring the diurnal rhythm of plasma aldosterone and its reaction to posture. The side localization of adenomas was best predicted from adrenal vein catheterization, and by calculation of the ratio between plasma aldosterone and cortisol. Computer tomography was helpful in 1 adult patient but, since the adenomas are small, the method rarely allows differentiation between adenoma and hyperplasia. 131I-cholesterol scintigraphy, being an non-invasive procedure, was received with enthusiasm. The method sometimes gave false positive or false negative results and should therefore be used only in instances where other methods have failed. Adrenal phlebography and arteriography have poor diagnostic value. In addition, adrenal phlebography is hazardous because of the risk of rupture of the adrenal vein. Thus, these latter methods should not be included in the procedures for topographic diagnosis in patients with primary aldosteronism.