Next Article in Journal
Transcriptome Sequencing of Dianthus spiculifolius and Analysis of the Genes Involved in Responses to Combined Cold and Drought Stress
Next Article in Special Issue
Clinical Utility of the Adrenocorticotropin Stimulation Test with/without Dexamethasone Suppression for Definitive and Subtype Diagnosis of Primary Aldosteronism
Previous Article in Journal
Pannexin- and Connexin-Mediated Intercellular Communication in Platelet Function
Previous Article in Special Issue
ATRAP Expression in Brown Adipose Tissue Does Not Influence the Development of Diet-Induced Metabolic Disorders in Mice
Article Menu
Issue 4 (April) cover image

Export Article

Open AccessReview
Int. J. Mol. Sci. 2017, 18(4), 848; doi:10.3390/ijms18040848

Subtype Diagnosis of Primary Aldosteronism: Is Adrenal Vein Sampling Always Necessary?

1
Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Via Genova 3, 10126 Torino, Italy
2
Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, 81377 Munich, Germany
3
Service of Radiology, University of Torino, 10126 Torino, Italy
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editors: Anastasia Susie Mihailidou, Jan Danser, Sadayoshi Ito, Fumitoshi Satoh and Akira Nishiyama
Received: 16 March 2017 / Revised: 11 April 2017 / Accepted: 12 April 2017 / Published: 17 April 2017
View Full-Text   |   Download PDF [251 KB, uploaded 17 April 2017]   |  

Abstract

Aldosterone producing adenoma and bilateral adrenal hyperplasia are the two most common subtypes of primary aldosteronism (PA) that require targeted and distinct therapeutic approaches: unilateral adrenalectomy or lifelong medical therapy with mineralocorticoid receptor antagonists. According to the 2016 Endocrine Society Guideline, adrenal venous sampling (AVS) is the gold standard test to distinguish between unilateral and bilateral aldosterone overproduction and therefore, to safely refer patients with PA to surgery. Despite significant advances in the optimization of the AVS procedure and the interpretation of hormonal data, a standardized protocol across centers is still lacking. Alternative methods are sought to either localize an aldosterone producing adenoma or to predict the presence of unilateral disease and thereby substantially reduce the number of patients with PA who proceed to AVS. In this review, we summarize the recent advances in subtyping PA for the diagnosis of unilateral and bilateral disease. We focus on the developments in the AVS procedure, the interpretation criteria, and comparisons of the performance of AVS with the alternative methods that are currently available. View Full-Text
Keywords: aldosterone; primary aldosteronism; adrenal vein sampling; cosyntropin stimulation; aldosterone producing adenoma; bilateral adrenal hyperplasia aldosterone; primary aldosteronism; adrenal vein sampling; cosyntropin stimulation; aldosterone producing adenoma; bilateral adrenal hyperplasia
Figures

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Supplementary material

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Buffolo, F.; Monticone, S.; Williams, T.A.; Rossato, D.; Burrello, J.; Tetti, M.; Veglio, F.; Mulatero, P. Subtype Diagnosis of Primary Aldosteronism: Is Adrenal Vein Sampling Always Necessary? Int. J. Mol. Sci. 2017, 18, 848.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Int. J. Mol. Sci. EISSN 1422-0067 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top