title: Primary aldosteronism due to unilateral adrenal microadenoma in an elderly patient: efficacy of selective adrenal venous sampling.
abstract: 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.
authors.affiliation: Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo. tamurayo@tmgh.metro.tokyo.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tamura
authors.forename: Jun-Ichiro
authors.initials: J
authors.lastname: Adachi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Chiba
authors.forename: Seijiro
authors.initials: S
authors.lastname: Mori
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takeda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kasuya
authors.forename: Takeo
authors.initials: T
authors.lastname: Murayama
authors.forename: Motoji
authors.initials: M
authors.lastname: Sawabe
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.forename: Hideki
authors.initials: H
authors.lastname: Ito
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Horiuchi
mesh_terms: 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
chemical_list: D000450:Aldosterone