title: [Differential diagnosis of primary aldosteronism by measurement of hybrid steroids using mass spectrometry].
abstract: Primary aldosteronism (PA), characterized by the autonomous hypersecretion of aldosterone, is the most common cause of secondary hypertension. Patients with PA have a higher risk of cardiovascular morbidity than essential hypertension. The two common subtypes of PA, aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA), should be differentiated, because the former is an indication for adrenalectomy, and the latter is treated by medication. 18-Hydroxycortisol and 18-oxocortisol, known as hybrid steroids, have been recognized as markers for the differentiation of aldosterone-producing adenoma and rare glucocorticoid remediable hyperaldosteronism from other subtypes of PA. Hybrid steroids have been measured using immunoassays such as enzyme-linked immunoassays; however, immunoassays for hybrid steroids are not widely used. Recently, liquid chromatography-tandem mass spectrometry (LC-MS/MS) for hybrid steroids was developed. The ability to measure hybrid steroids using LC-MS/MS will be useful for the differential diagnosis of subtypes of PA.
authors.forename: Norio
authors.initials: N
authors.lastname: Wada
authors.forename: Shigeki
authors.initials: S
authors.lastname: Jin
authors.forename: Shu-Ping
authors.initials: SP
authors.lastname: Hui
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Yanagisawa
authors.forename: Takao
authors.initials: T
authors.lastname: Kurosawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Chiba
mesh_terms: D003937:Diagnosis, Differential; D000075222:Essential Hypertension; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000737:chemistry; D006929:Hyperaldosteronism / Q000175:diagnosis*; D006973:Hypertension / Q000175:diagnosis; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D006854:Hydrocortisone