Renin and aldosterone measurements after captopril and supine position in differential diagnosis of adenoma and hyperplasia in primary aldosteronism.

Abstract Increased excretion of 18-hydroxycortisol has been proposed as a specific biochemical marker for differential diagnosis of primary aldosteronism. We describe the development of a direct RIA with an 125I label that permits measurement of the steroid in less than or equal to 0.5 microL of urine or less than or equal to 25 microL of plasma. For control subjects, the mean concentrations of 18-hydroxycortisol in urine and plasma were 310 (SD 178) nmol/24 h (n = 32) and 2.27 (SD 0.80) nmol/L (n = 37), respectively; patients with Conn's adenoma or glucocorticoid-remediable aldosteronism had values for urine in the range 1084 to 6534 nmol/24 h and concentrations in plasma ranging from 6.49 to 31.20 nmol/L. Patients with idiopathic zona glomerulosa hyperplasia had values for urine and plasma ranging from 353 to 734 nmol/24 h and from 0.26 to 6.60 nmol/L, respectively. Concentrations of 18-hydroxycortisol in urine clearly discriminate patients with idiopathic hyperplasia from those with other forms of primary aldosteronism, but further work is required to assess the diagnostic accuracy of determinations in plasma.

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Evaluation of Diagnostic Tests in the Differential Diagnosis of Primary Aldosteronism: Unilateral Adenoma Versus Bilateral Micronodular Hyperplasia

The Journal of Urology ◽

10.1016/s0022-5347(17)35781-6 ◽

1993 ◽

Vol 150 (5 Part 1) ◽

pp. 1365-1368 ◽

Cited By ~ 36

Author(s):

Philip E. Gleason ◽

Myron H. Weinberger ◽

J. Howard Pratt ◽

Richard Bihrle ◽

Jim dugan ◽

...

Keyword(s):

Differential Diagnosis ◽

Primary Aldosteronism ◽

Diagnostic Tests

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DIFFERENTIAL DIAGNOSIS OF PRIMARY ALDOSTERONISM SUBTYPES USING ADRENAL VEIN SAMPLING: EVALUATION OF THE GERMANS CONNʼS REGISTRY: 4D.07

Journal of Hypertension ◽

10.1097/01.hjh.0000378866.96943.62 ◽

2010 ◽

Vol 28 ◽

pp. e217

Author(s):

O Vonend ◽

N Ockenfels ◽

M Reincke ◽

B Allolio ◽

K Lang ◽

...

Keyword(s):

Differential Diagnosis ◽

Primary Aldosteronism ◽

Adrenal Vein ◽

Adrenal Vein Sampling

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Differential diagnosis of primary aldosteronism subtypes

Current Hypertension Reports ◽

10.1007/s11906-009-0038-1 ◽

2009 ◽

Vol 11 (3) ◽

pp. 217-223 ◽

Cited By ~ 26

Author(s):

Paolo Mulatero ◽

Chiara Bertello ◽

Andrea Verhovez ◽

Denis Rossato ◽

Giuseppe Giraudo ◽

...

Keyword(s):

Differential Diagnosis ◽

Primary Aldosteronism

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Primary aldosteronism. Part II Differential diagnosis of primary hyperaldosteronism and pseudoaldosteronism

Clinical Endocrinology ◽

10.1046/j.1365-2265.1996.00829.x ◽

1996 ◽

Vol 45 (1) ◽

pp. 61-71 ◽

Cited By ~ 2

Author(s):

Michel Vallotton

Keyword(s):

Differential Diagnosis ◽

Primary Aldosteronism ◽

Primary Hyperaldosteronism

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Deoxycorticosterone Producing Tumor as a Cause of Resistant Hypertension

Case Reports in Medicine ◽

10.1155/2010/372719 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Saurabh Gupta ◽

Jose Melendez ◽

Apurv Khanna

Keyword(s):

Differential Diagnosis ◽

Plasma Renin Activity ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Resistant Hypertension ◽

Primary Aldosteronism ◽

Plasma Renin ◽

Plasma Aldosterone ◽

Imaging Studies ◽

Plasma Aldosterone Concentration

We describe a young woman with longstanding resistant hypertension. Evaluation for renal artery stenosis and primary aldosteronism was unrevealing. In this setting of a suppressed plasma aldosterone concentration (PAC) and a suppressed plasma renin activity (PRA), a differential diagnosis of a deoxycorticosterone (DOC) producing tumor was entertained. Biochemical and imaging studies confirmed this diagnosis. Rare and novel DOC producing tumors are an important cause of resistant hypertension.

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