6.12 Long-Term Effects of Pharmacological and Surgical Treatment on Cardiovascular Parameters in Patients with Primary Aldosteronism

AbstractPrimary hyperparathyroidism (PHPT) in children is thought to be extremely rare. The exact incidence is unknown and little is known of the characteristics of the disease. We reviewed our experience with PHPT to better characterize these patients.We carried out a retrospective study in 12 patients (age 9–16 years) who had surgical treatment between 2001 and 2011 in a single institution.There were 5 male subjects and 7 female subjects. The diagnosis of PHPT in pediatric patients is frequently delayed with an average time of 41 months. The main signs of PHPT were urinary and bone disorders, as well as non-specific signs. All patients had preoperative localization studies prior to operation. Combined using of neck sonography, MIBI-scintigraphy and CT and/or MRI, our patients had a positive predictive value of 100%. After operation, all patients were confirmed to have parathyroid adenoma. 1 patient had 2 adenomas, 1 of which was an ectopic adenoma located in the mediastinum. 9 patients experienced symptomatic hypocalcemia postoperatively. No patients had any serious long-term effects from parathyroidectomy at our institution. All patients were cured after removal of the parathyroid adenoma. No permanent complication was observed for all patients.PHPT in children is rare, the commonest signs are urinary and bone tissue impairment, as well as non-specific signs. Evaluation of serum calcium and PTH levels is diagnostic in suspected patients. Preoperative localization is essential. Surgery is without significant complications. Surgical treatment of PHPT is curative and definitive.

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Are We Aiming for Cure or Lifelong Treatment of Hypertension? All Doctors Need To Be Aware of Primary Aldosteronism. A Nationwide Study With Up To 8-Year Follow-Up

10.21203/rs.3.rs-980358/v1 ◽

2021 ◽

Author(s):

Hrafnhildur Gunnarsdóttir ◽

Gudbjorg Jonsdottir ◽

Gudjon Birgisson ◽

Jon Gudmundsson ◽

Helga Agusta Sigurjonsdottir

Keyword(s):

Treatment Response ◽

Primary Aldosteronism ◽

Diagnostic Procedures ◽

University Hospital ◽

Long Term Effects ◽

Specialized Treatment ◽

Tertiary Referral Center ◽

Nationwide Observational Study

Abstract Purpose Long term follow-up studies on primary aldosteronism (PA) diagnosis, treatment response and comparison of the two major subgroups – unilateral (UD) and bilateral disease (BD) – are lacking. While adrenalectomy for UD is considered effective, less is known about long-term effects of specialized treatment for BD. We present the results from our nationwide observational study, executed at Landspitali University Hospital, tertiary referral center. We aim to review results of diagnostic procedures and histopathology for PA patients diagnosed in 2012-2016 in Iceland, compare UD and BD and assess treatment response. Methods A total of 32 PA patients aged 28-88 years were diagnosed and treated according to current guidelines. Adrenalectomy was used for AVS-confirmed UD and mineralocorticoid receptor antagonists for BD. Results The majority of patients had BD, roughly half of them had a unilateral nodule. With specialized treatment, a reduction was seen in UD and BD in systolic blood pressure (BP) (p<0,001, both groups), antihypertensive drug count (p=0,002 and p=0,04, respectively) and need for potassium supplementation (p<0,001, both groups). Diastolic BP decreased significantly in UD (p<0,001). Conclusion Our results show similarly good treatment response in both subgroups. Ratio of hypokalemia and number of cases indicates severe PA underdiagnosis in Iceland. Adrenal nodules diagnosed using CT can be misleading and AVS is mandatory in diagnosing unilateral vs bilateral PA.

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