The significance of elevated levels of plasma 18-hydroxycorticosterone in patients with primary aldosteronism.
Plasma 18-hydroxycorticosterone (180HB) concentration was measured in 23 patients with primary aldosteronism. After overnight recumbency, the levels were markedly elevated and were 6 times higher in patients with aldosterone-producing adenomas than in patients with hyperplasia. A value of 100 ng/dl or greater at 0800 h after overnight recumbency distinguished an adenoma from hyperplasia. There was no overlap of values, as was observed with plasma aldosterone concentration (PAC) at 0800 h and after 4 h of upright posture at 1200 h. There was a significant negative correlation between the ratio of 180HB to PAC and the potassium concentration in patients with primary aldosteronism due to hyperplasia. Potassium repletion with potassium chloride and/or spironolactone in patients with aldosterone-producing adenomas decreased the 180HB:PAC ratio by decreasing 180HB and increasing PAC. 180HB is an effective discriminator of an adenoma and may be a useful marker of the events in late aldosterone synthesis.
D015069:18-Hydroxycorticosterone / Q000097:blood*; D000236:Adenoma / Q000097:blood; D000310:Adrenal Gland Neoplasms / Q000097:blood; D000308:Adrenocortical Hyperfunction / Q000097:blood; D000450:Aldosterone / Q000097:blood; D003345:Corticosterone / Q000031:analogs & derivatives*; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000209:etiology; D011187:Posture; D011188:Potassium / Q000097:blood; D011189:Potassium Chloride / Q000494:pharmacology; D012083:Renin / Q000097:blood; D013148:Spironolactone / Q000494:pharmacology
D013148:Spironolactone; D000450:Aldosterone; D015069:18-Hydroxycorticosterone; D011189:Potassium Chloride; D012083:Renin; D011188:Potassium; D003345:Corticosterone