Endocrinology Medical News about primary aldosteronism; adrenal vein sampling

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Systematic Review: Diagnostic Procedures to Differentiate Unilateral From Bilateral Adrenal Abnormality in Primary Aldosteronism
Annals of Internal Medicine, 09/02/09

Kempers MJE et al. – Primary aldosteronism can involve 1 or both adrenal glands. Surgery is indicated only for unilateral disease. Experts prefer adrenal vein sampling (AVS) to localize the source, but many physicians rely on computed tomography (CT) or magnetic resonance imaging (MRI)...The authors reviewed 38 studies that compared localization by CT/MRI and adrenal vein sampling (AVS). In 37.8% of 950 patients, CT/MRI results disagreed with AVS results. Based on CT/MRI alone, the following would have occurred: surgery for bilateral disease in 14.6% of patients, medical treatment for unilateral disease in 19.1%, and removal of the wrong adrenal in 3.9%. Relying only on CT/MRI may lead to inappropriate treatment of patients with primary aldosteronism.

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Case detection, diagnosis, and treatment of patients with primary aldosteronism: an Endocrine Society clinical practice guideline
European Journal of Endocrinology, 10/14/09 Relevance Score: 65%

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