title: [The difficulties in differential diagnosis of primary aldosteronism subtypes in women with strokes at a young age].
abstract: In patients with primary aldosteronism (PA), it is fundamental to distinguish between subtypes that benefit from different treatment. The authors describe difficulties in differential diagnosis in a case of 46 year old women with PA and two strokes in the past. Based on high plasma and urine aldosterone concentration, low plasma renin activity (PRA), very high aldosterone/PRA ratio and unilateral macroadenoma detected in computed tomography, aldosterone producing adenoma was diagnosed and the patient was performed unilateral adrenalectomy. Despite the surgical treatment the patient still presented with clinical and biochemical PA symptoms. Moreover, histological examination suggested adrenal hyperplasia, and laboratory tests were typical for glucocorticoid-remediable aldosteronism. Unfortunately, we didn't find a chimeric CYP 11beta1/CYP 11beta2 gene. Finally, bilateral adrenal hyperplasia was diagnosed and medical treatment with aldosterone antagonist was initiated.
authors.affiliation: Katedra i Klinika Endokrynologii, Diabetologii i Leczenia Izotopami, Akademia Medyczna, Wrocław.
authors.forename: Anna
authors.initials: A
authors.lastname: Bohdanowicz-Pawlak
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Szymczak
authors.forename: Joanna
authors.initials: J
authors.lastname: Jakubowska
authors.forename: Anna
authors.initials: A
authors.lastname: Brona
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis; D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology; D000315:Adrenalectomy; D000450:Aldosterone / Q000097:blood / Q000652:urine; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006965:Hyperplasia; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D012083:Renin / Q000097:blood; D013148:Spironolactone / Q000627:therapeutic use; D020521:Stroke / Q000150:complications
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D012083:Renin