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Chapter-066 Primary Aldosteronism

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Bhansali Anil
2. Gangadhar Prathosh
ISBN
9789351526476
DOI
10.5005/jp/books/12535_82
Edition
2/e
Publishing Year
2015
Pages
8
Author Affiliations
1. Postgraduate Institute of Medical Education and Research, Chandigarh, India, Institute of Medical Education and Research, Chandigarh, India, P.G.I., Chandigarh, India, Post-Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, India, PGIMER, Chandigarh, India, Post Graduate Institute of Medical Education and Research, Chandigarh, India, ESICON–2014, PGIMER, Chandigarh, India
2. IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India
Chapter keywords
Oral sodium loading, saline infusion, fludrocortisone suppression, adrenal vein sampling, functional scintigraphy

Abstract

Primary aldosteronism (PA) is a disease that caused by curable arterial hypertension. It is characterized by the autonomous inappropriately excessive production of aldosterone, with suppression of renin-angiotensin-system. The most general presentation of the disease, with hypokalemia present in only the more severe cases. Screening with ARR is the current typical of care value based on plasma aldosterone concentration (PAC) and on levels of renin. Confirmatory tests (oral sodium loading, saline infusion, fludrocortisone suppression, and captopril challenge), Imaging, adrenal vein sampling (AVS), functional scintigraphy, CT scan and MRI are useful for diagnostic purposes. Pros and cons of surgical versus medical management should be discussed with the patient before initiating treatment.

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