Adrenalectomy for Primary Aldosteronism
Authors: William F. Young, Anna M. Sawka, Jon A. van Heerden
Journal: Annals of Internal Medicine (2003)

Letters21 January 2003Adrenalectomy for Primary AldosteronismWilliam F. Young Jr, MD, Anna M. Sawka, MD, and Jon A. van Heerden, MDWilliam F. Young Jr, MDMayo Clinic; Rochester, MN 55905 (Young Jr., Anna, Jon, Heerden)Search for more papers by this author, Anna M. Sawka, MDMayo Clinic; Rochester, MN 55905 (Young Jr., Anna, Jon, Heerden)Search for more papers by this author, and Jon A. van Heerden, MDMayo Clinic; Rochester, MN 55905 (Young Jr., Anna, Jon, Heerden)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-2-200301210-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Martinez makes an important point regarding the key role of adrenal venous sampling in the subtype evaluation of primary aldosteronism. In many patients with primary aldosteronism, CT imaging may reveal normal-appearing adrenals, minimal unilateral adrenal limb thickening, a unilateral microadenoma ( 1 cm), or bilateral macroadenomas. A small aldosterone-producing adenoma may be labeled incorrectly as bilateral idiopathic hyperplasia on the basis of CT findings of bilateral nodularity or normal-appearing adrenals (1). Also, apparent adrenal microadenomas and macroadenomas may represent areas of hyperplasia or nonfunctioning cortical adenomas, and unilateral adrenalectomy would be inappropriate.Patients with aldosterone-producing adenomas have ...References1. Young WF Jr, Stanson AW, Grant CS, Thompson GB, van Heerden JA. Primary aldosteronism: adrenal venous sampling. Surgery. 1996; 120:913-9; discussion 919-20. [PMID: 8957473] Google Scholar2. Blumenfeld JD, Sealey JE, Schlussel Y, Vaughan ED, Sos TA, Atlas SA, . Diagnosis and treatment of primary hyperaldosteronism. Ann Intern Med. 1994;121:877-85. [PMID: 7978702] LinkGoogle Scholar3. Young WF, Hogan MJ. Renin-independent hypermineralocorticoidism. Trends Endocrinol Metab. 1994;5:97-106. CrossrefMedlineGoogle Scholar4. Young WF. Primary aldosteronism: a common and curable form of hypertension. Cardiol Rev. 1999;7:207-14. [PMID: 10423672] CrossrefMedlineGoogle Scholar5. Kloos RT, Gross MD, Francis IR, Korobkin M, Shapiro B. Incidentally discovered adrenal masses. Endocr Rev. 1995;16:460-84. [PMID: 8521790] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Mayo Clinic; Rochester, MN 55905 (Young Jr., Anna, Jon, Heerden) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrimary Aldosteronism: Factors Associated with Normalization of Blood Pressure after Surgery Anna M. Sawka , William F. Young Jr. , Geoffrey B. Thompson , Clive S. Grant , David R. Farley , Cynthia Leibson , and Jon A. van Heerden Adrenalectomy for Primary Aldosteronism David G. Martinez Metrics Cited byA step by step approach in differential diagnosing of adrenal incidentaloma (epinephroma), (with comments on the new Clinical Practice Guidelines of the European Society of Endocrinology) 21 January 2003Volume 138, Issue 2Page: 158-159KeywordsAdenomasAdrenalectomyAldosteroneBlood plasmaComputed axial tomographyHypertension ePublished: 21 January 2003 Issue Published: 21 January 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...