Characteristics of aldosterone-producing adenoma responsive to upright posture.
A small subgroup of primary aldosteronism due to aldosteronoma, named aldosterone-producing renin-responsive adenoma (AP-RA), has been reported to masquerade as idiopathic hyperaldosteronism (IHA) because of the responsiveness of the plasma aldosterone concentration (PAC) to upright posture (UP). We found two patients with AP-RA in 19 patients with aldosteronoma who were examined by UP stimulation and were treated surgically. In 17 patients with typical aldosterone-producing adenoma (APA), PAC decreased or increased only slightly (less than 200% of the basal level); in contrast, it increased to over 300% of the basal level in two patients with AP-RA. The two groups were comparatively studied as to their hormonal levels, adrenal computed tomography (CT) scan and histological findings in order to clarify the characteristics of AP-RA. Basal PAC was within the normal range (11.1 and 13.0 ng/dl) in AP-RA but in APA it ranged from 14.8 to 58.1 ng/dl with a mean of 32.3 +/- 2.7 ng/dl. The diameters of the adenoma in AP-RA were apparently smaller (6 and 9 mm) than those in APA ranged from 10 to 25 mm with a mean of 15.5 +/- 1.1 mm. After a contrast medium was injected at CT scan, the density of the normal adrenal gland adjacent to the adenoma increased but that of the adenoma did not in APA, making a clear distinction between the adenoma and the gland. On the other hand, the density of the adenoma and gland increased to almost the same degree in AP-RA.(ABSTRACT TRUNCATED AT 250 WORDS)
Toraya
S
S
Department of Medicine, Tokyo Women's Medical College, Japan.
Nomura
K
K
Kono
A
A
Aiba
M
M
Ogasawara
M
M
Kikuchi
C
C
Demura
H
H
D000306:Adrenal Cortex Neoplasms / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D018246:Adrenocortical Adenoma / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D000328:Adult; D000450:Aldosterone / Q000097:blood*; D004232:Diuretics; D005260:Female; D005665:Furosemide; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011187:Posture; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D004232:Diuretics; D000450:Aldosterone; D005665:Furosemide