Primary aldosteronism due to unilateral adrenal microadenoma in an elderly patient: efficacy of selective adrenal venous sampling.
We encountered a case of drug-resistant hypertension and hypokalemia. Laboratory data suggested primary aldosteronism (PA). Computed tomography imaging appeared normal for a long duration with a left-sided nodule appearing far later; adrenal scintigraphy was first normal, and the second test showed right-sided uptake. However, a repeat selective adrenal venous sampling (SAVS) indicated a left-sided lateralization of the hypersecretion of aldosterone. Left adrenectomy was performed, and his clinical symptoms improved. The histopathological findings demonstrated the aldosterone-producing microadenoma with secondary micronodules. In conclusion, SAVS should be performed to determine the laterality of PA with obscure CT imaging.
Tamura
Yoshiaki
Y
Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo. tamurayo@tmgh.metro.tokyo.jp
Adachi
Jun-Ichiro
J
Chiba
Yuko
Y
Mori
Seijiro
S
Takeda
Kazuhiro
K
Kasuya
Yutaka
Y
Murayama
Takeo
T
Sawabe
Motoji
M
Sasano
Hironobu
H
Araki
Atsushi
A
Ito
Hideki
H
Horiuchi
Toshiyuki
T
D000306:Adrenal Cortex Neoplasms / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000311:Adrenal Glands / Q000098:blood supply*; D018246:Adrenocortical Adenoma / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D014680:Veins
D000450:Aldosterone