ALDOSTERONE‐PRODUCING ADENOMAS RESPONSIVE TO ANGIOTENSIN POSE PROBLEMS IN DIAGNOSIS
- 1 March 1987
- journal article
- research article
- Published by Wiley in Clinical and Experimental Pharmacology and Physiology
- Vol. 14 (3) , 175-179
- https://doi.org/10.1111/j.1440-1681.1987.tb00371.x
Abstract
1. A subgroup of patients with aldosterone-producing adenoma (APA) have been identified who lack many of the biochemical features regarded as characteristic of APA and used to distinguish APA from bilateral adrenal hyperplasia. 2. In these patients, aldosterone is responsive to infused angiotensin II (angiotensin-responsive APA), which explains their uncharacteristic responses to upright posture, saline infusion and fludrocortisone acetate administration. 3. The angiotensin-responsiveness of these patients may derive from the contralateral adrenal gland, since renin levels are less completely suppressed in angiotensin-responsive APA than in angiotensin-unresponsive APA. 4. However, while the excretion of 18-oxo-cortisol was consistently increased in angiotensin-unresponsive APA, it was normal in angiotensin-responsive APA, consistent with biochemical and biosynthetic distinctiveness residing in the tumours. 5. Angiotensin-responsive APA should always be considered as an alternative diagnosis to bilateral hyperplasia causing primary aldosteronism.Keywords
This publication has 12 references indexed in Scilit:
- DISTINGUISHING ALDOSTERONE‐PRODUCING ADENOMA FROM OTHER FORMS OF HYPERALDOSTERONISM AND LATERALIZING THE TUMOUR PRE‐OPERATIVELYClinical and Experimental Pharmacology and Physiology, 1986
- The changing clinical spectrum of primary aldosteronismThe American Journal of Medicine, 1983
- Response of aldosterone and 18-hydroxycorticosterone to angiotensin II in normal subjects and patients with essential hypertension, Conn's syndrome, and nontumorous hyperaldosteronism.Hypertension, 1981
- THE DIAGNOSIS OF PRIMARY HYPERALDOSTERONISMThe Lancet, 1981
- Primary AldosteronismAnnals of Internal Medicine, 1979
- PRIMARY ALDOSTERONISM: INABILITY TO DIFFERENTIATE UNILATERAL FROM BILATERAL ADRENAL LESIONS BY VARIOUS ROUTINE CLINICAL AND LABORATORY DATA AND BY PERIPHERAL PLASMA ALDOSTERONEActa Endocrinologica, 1978
- Plasma Aldosterone Response to ACTH in Primary Aldosteronism and in Patients with Low Renin Hypertension*Journal of Clinical Endocrinology & Metabolism, 1978
- Circadian Rhythm and Effect of Posture on Plasma Aldosterone Concentration in Primary AldosteronismJournal of Clinical Endocrinology & Metabolism, 1976
- Anomalous Postural Response of Plasma Aldosterone Concentration In Patients With Aldosterone-Producing Adrenal AdenomaJournal of Clinical Endocrinology & Metabolism, 1973
- Activation of aldosterone secretion in primary aldosteronismJournal of Clinical Investigation, 1969