[Causes of delaying diagnosis of primary hyperaldosteronism with adrenal adenoma and strategy therefore].
OBJECTIVE
To analyze the causes of delaying diagnosis of primary hyperaldosteronism with adrenal adenoma and discuss corrective strategies.


METHODS
The clinical data of 267 patients of primary hyperaldosteronism with adrenal adenoma confirmed by operation 1995 - 2005 were analyzed.


RESULTS
Confirmed diagnosis was made after a duration of (92 +/- 64) months (3 - 40 years) after the first visit. 78.3% of the hospitals where the patients with hypertension made their first visits were grade II hospitals, and 21.3% of them were grade III hospitals. 95.9% of the patients were diagnosed as with primary hypertension at the first visit without receiving relevant imaging examination of adrenal and endocrine examination. 87.3% of the patients with extremity weakness numbness of finger tips were diagnosed as with hypokalemia and more than 10% of them failed to receive examination of blood potassium. Adrenal adenoma was discovered by computed tomography with thin coat screening in 267 patients and by ultrasonography in 151 patients.


CONCLUSIONS
Primary hyperaldosteronism should be considered and screened in all young patients with hypertension. Plasma aldosterone/rennin ratio is an effective mark in screening. The first choice diagnostic means for primary hyperaldosteronism should be computed tomography with screening by coat 2 - 4 mm thin.
Yan
Qiu-zhe
QZ
Department of Urology, Beijing Chaoyang Hospital, Beijing 100043, China.
Li
Han-zhong
HZ
Pan
Dong-liang
DL
D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000175:diagnosis*; D018246:Adrenocortical Adenoma / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D012085:Chymosin / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000175:diagnosis*; D006973:Hypertension / Q000175:diagnosis; D007008:Hypokalemia / Q000175:diagnosis; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D014408:Biomarkers, Tumor; D000450:Aldosterone; D012085:Chymosin