No abstract available.
Diagnosis* ; Hyperaldosteronism*

Humans ; Aldosterone ; Hyperaldosteronism/diagnosis* ; Adrenal Gland Neoplasms/complications* ; Adenoma/diagnosis*

Hypertension and atherosclerosis are the most important factors contributing to the development of aortic dissection. Primary aldosteronism is a rare cause of hypertension. The concurrence of aortic dissection is very rare in primary aldosteronism. However, when aortic dissection is found as a life-threatening complication of primary aldosteronism, then the diagnosis of primary aldosteronism is important because the therapeutic intervention can be curative. Only 3 cases of primary aldosteronism with aortic dissection have been reported in the literature. We report here on a case of primary aldosteronism with aortic dissection, which was treated by laparoscopic adrenalectomy. We lowered the blood pressure with antihypertensive drugs and potassium replacement was done to treat the aortic dissection. After stabilization of aortic dissection, we removed his left adrenal mass by laparoscopic adrenalectomy. Postoperatively, the patient's blood pressure has been within normal limits and the serum potassium increased to a normal level without supplementation. The aortic dissection has remained in a stable state
Adrenalectomy ; Antihypertensive Agents ; Atherosclerosis ; Blood Pressure ; Diagnosis ; Hyperaldosteronism* ; Hypertension ; Potassium

Hypertension and atherosclerosis are the most important factors contributing to the development of aortic dissection. Primary aldosteronism is a rare cause of hypertension. The concurrence of aortic dissection is very rare in primary aldosteronism. However, when aortic dissection is found as a life-threatening complication of primary aldosteronism, then the diagnosis of primary aldosteronism is important because the therapeutic intervention can be curative. Only 3 cases of primary aldosteronism with aortic dissection have been reported in the literature. We report here on a case of primary aldosteronism with aortic dissection, which was treated by laparoscopic adrenalectomy. We lowered the blood pressure with antihypertensive drugs and potassium replacement was done to treat the aortic dissection. After stabilization of aortic dissection, we removed his left adrenal mass by laparoscopic adrenalectomy. Postoperatively, the patient's blood pressure has been within normal limits and the serum potassium increased to a normal level without supplementation. The aortic dissection has remained in a stable state
Adrenalectomy ; Antihypertensive Agents ; Atherosclerosis ; Blood Pressure ; Diagnosis ; Hyperaldosteronism* ; Hypertension ; Potassium

BACKGROUND: Since the diagnostic value of aldosterone to renin ratio (ARR) calculated by plasma renin concentration (PRC) or plasma renin activity (PRA) is still inconclusive, we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA, so as to provide guidance for clinical diagnosis. METHODS: We searched PubMed, Embase, and Cochrane Library from the establishment of the database to March 2021. We included studies that report the true positive, false positive, true negative, and false negative values for the diagnosis of primary aldosteronism, and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data. RESULTS: The pooled results showed that ARR (plasma aldosterone concentration [PAC]/PRC) had a sensitivity of 0.82 (95% confidence interval [CI]: 0.78-0.86), a specificity of 0.94 (95% CI: 0.92-0.95), a positive-likelihood ratio (LR) of 12.77 (95% CI: 7.04-23.73), a negative LR of 0.11 (95% CI: 0.07-0.17), and symmetric area under the curve (SAUC) of 0.982, respectively. Furthermore, the diagnostic odds ratio (DOR) of ARR (PAC/PRC) was 180.21. Additionally, the pooled results showed that ARR (PAC/PRA) had a sensitivity of 0.91 (95% CI: 0.86-0.95), a specificity of 0.91 (95% CI: 0.90-0.93), a positive LR of 7.30 (95% CI: 2.99-17.99), a negative LR of 0.10 (95% CI: 0.04-0.26), and SAUC of 0.976, respectively. The DOR of ARR (PAC/PRA) was 155.52. Additionally, we conducted a subgroup analysis for the different thresholds (<35 or ≥35) of PAC/PRC. The results showed that the DOR of the cut-off ≥35 groups was higher than the cut-off <35 groups (DOR = 340.15, 95% CI: 38.32-3019.66; DOR = 116.40, 95% CI = 23.28-581.92). CONCLUSIONS The research results suggest that the determination of ARR (PAC/PRC) and ARR (PAC/PRA) was all effective screening tools for PA. The diagnostic accuracy and diagnostic value of ARR (PAC/PRC) are higher than ARR (PAC/PRA). In addition, within a certain range, the higher the threshold, the better the diagnostic value.
Aldosterone ; Area Under Curve ; Humans ; Hyperaldosteronism/diagnosis* ; Hypertension ; Renin

Between 1980 and 1989, our experience of surgical management with 21 adrenal diseases was presented. There were 3 cases of Cushing's syndrome, 3 of primary aldosteronism, 6 of pheochromo cytoma, 5 of neuroblastoma, 2 of extraadrenal paraganglioma, 1 of adrenocortical carcinoma and 1 of adrenal cyst. The use of advanced radiographic and laboratory procedures resulted in the refinement of diagnosis and localization of tumors, enabling better surgical management of adrenal disorders. Among those, 19 cases underwent unilateral adrenalectomy and 2 cases of Cushing's disease underwent bilateral adrenalectomy. Surgical approaches to the adrenal gland were transperitoneal in 16 cases and extraperitoneal in 5 cases. Operative complications occurred in 11 cases. The incidence, however, of complications related to the operative approach was not significant except in 2 cases of postoperative ileus.
Adrenal Glands ; Adrenalectomy ; Adrenocortical Carcinoma ; Cushing Syndrome ; Diagnosis ; Hyperaldosteronism ; Ileus ; Incidence ; Neuroblastoma ; Paraganglioma

BACKGROUND: Acute hypokalemic paralysis, a clinical syndrome characterized by acute systemic weakness and low serum potassium, is a rare but treatable cause of acute weakness. The aim of our study is to analyze the cause of hypokalemic paralysis and to define clinical characteristics of hypokalemic paralysis. METHODS: Hypokalemia was defined as a serum potassium concentration less than 3.0 mEq/L in this study. A total 31 patients with hypokalemic paralysis (male 71%, mean age; 35.7 +/- 14.3 years) have been studied retrospectively from June 1994 to March 2004 for the evaluation of clinical characteristics. According to the pathophysiology of hypokalemia, patients were divided into the potassium renal loss group (n=9) and the potassium shift group (n=14). We calculate the UK/UCr (mmol/mmol) ratio, Transtubular K+ concentration gradient (TTKG) and compared the results between two groups. RESULTS: The cause of hypokalemic paralysis was hyperthyroidism (45.2%), medication (19.4%), renal disease (6.5%), hyperaldosteronism (3.2%), poor oral intake (3.2%), vomiting (3.2%), and unknown origin (19.4%). There was a significant difference of UK/UCr ratio (p=0.046) but no significant difference of TTKG (p=0.116) between the potassium loss and shift groups. CONCLUSION: The most common cause of acute hypokalemic paralysis is hyperthyroidism. The UK/UCr ratio is more useful measure than TTKG in differentiation of potassium loss and potassium shift as a cause of hypokalemia.
Creatinine ; Diagnosis, Differential* ; Humans ; Hyperaldosteronism ; Hyperthyroidism ; Hypokalemia ; Paralysis* ; Potassium ; Retrospective Studies ; Vomiting

Diagnostic accuracy in localizing tumors by means of computed tomography (CT), adrenal scintigraphy, ultrasonography (US) and IVP was compared in 12 cases of adrenal tumors which were experienced during last 6 years. The following results were obtained : 1. The patient group consists of 8 pheochromocytomas, 3 primary aldosteronism, and 1 Cushing syndrome. 2. For the initial diagnosis of adrenal cortical tumor (primary aldosteronism, Cushing syndrome) CT and adrenal scintigraphy are reliable and noninvasive modalities with high diagnostic accuracy, whereas in pheochromocytoma, US, CT and adrenal scintigraphy was useful. 3. Invasive diagnostic modalities such as aortography, venous sampling of adrenal gland and venography should be restricted to localizing adrenal tumors cannot be diagnosed by previous non -invasive diagnostic modalities.
Adrenal Glands ; Aortography ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Pheochromocytoma ; Phlebography ; Radionuclide Imaging ; Ultrasonography

Aldosterone ; blood ; Humans ; Hyperaldosteronism ; classification ; diagnosis ; Hypertension ; complications ; Mass Screening ; Renin ; blood ; Renin-Angiotensin System

The CT findings of the adrenal disease in a total of 52 patients were analysed. 39 patients of them wereverified at operation and composed of 22 patients of Cushing's syndrome, 11 patients of pheochromocytoma, 6patients of aldosteronism. The remainder was finally diagnosed on the basis of compelling clinical and biochemical evidence. Aldosteronoma is very small (all under 3cm), round or oval mass with homogeneous low density, but pheochromocytoma is relatively large mass (all beyond 3cm) with heterogeneous or isodense comparing to pancreaticdensity. Size and density of Cushing's adenoma has transitional character between aldosteronoma andpheochromocytoma. Overall diagnostic accuracy, sensitivity and specificity of CT in adrenal tumor/adrenal diseaseare 96.2%/87%. 96.4%/78.9% and 95.7%/97.7% respectively. The relative low sensitivity of adrenal disease(78.9%) isdue to inclusion of normal sized bilateral hyperplasia. Of 28 adrenal tumors, 27 were correctly diagnosed by CT,and there were one false positive and one false negative diagnosis. CT is a highly accurate non-invasive method inlocalization of adrenal tumors and differentiation of the tumors from hyperplasia.
Adenoma ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Hyperplasia ; Methods ; Pheochromocytoma ; Sensitivity and Specificity