Spectrum of Clinical and Pathogenetic Forms of Primary Hyperaldosteronism
The aim of the study was to investigate the spectrum of different pathogenetic forms of primary hyperaldosteronism on the clinical data of Ukrainian Scientific and Practical Center of Endocrine Surgery, Endocrine Organs and Tissues Transplantation within the period of 1996–2014 yrs. Results of diagnosis and treatment of 474 surgical and therapeutical patients were retrospectively studied. All patients were undergone screening of serum potassium, aldosteron-renin ratio, confirmation tests, multi-spiral computed tomography. Selective adrenal vein sampling was performed in 63 cases. Analysis of separate clinical and pathogenetic forms demonstrated the following sharing: idiopathic adrenal hyperplasia — 235 (49.6 %), aldosteron-producing adenoma — 195 (41.1 %), primary (unilateral) adrenal hyperplasia — 36 (7.6 %), familial forms — 6 (1.3 %) (including glucocorticoid-remediable aldosteronism — 4, FH II — 2), adrenocortical carcinoma — 2 (0.4 %). 255 patients with primary hyperaldosteronism were operated by unilateral laparoscopic adrenalectomy. Among 219 patients from the group of conservative treatment primary hyperaldosteronism glucocorticoid-remediable aldosteronism was suspected in 22 patients and was confirmed by presumptive treatment with dexamethasone in 4 patients who continued the successful treatment with this medication dosed 0.25–0.5 mg daily. The rest of patients received treatment with antagonists of mineralocorticoids receptors.
It was clearly shown that in-time diagnosis of distinct form of primary hyperaldosteronism allows chose adequate mode of therapy.
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