Management of Aldosteronoma
Primary hyperaldosteronism is a condition of excess production of aldosterone from the adrenal gland. The condition may be caused by a single adenoma or idiopathic hyperplasia of the adrenal glands. Clinically, primary hyperaldosteronism often results in difficult-to-control hypertension. Biochemical evaluation should include a plasma aldosterone-to-renin ratio, which when greater than 35 is highly suggestive of primary hyperaldosteronism. Imaging should include a non-contrast computed tomography (CT) scan. Adrenal nodules associated with primary hyperaldosteronism are typically 1–3 cm in size. Confirmatory lateralization with adrenal vein sampling should be considered when imaging is not clear. Biopsy of the adrenal gland should never be performed. For patients with unilateral disease, the treatment of choice is a laparoscopic adrenalectomy. In the setting of bilateral disease, patients should be medically managed with spironolactone or eplerenone.
KeywordsConn’s Syndrome Spironolactone Eplerenone Laparoscopic adrenalectomy
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