The Diagnostic Value of Urinary Free 18-Hydroxycorticosterone in Primary Aldosteronism
18-hydroxycorticosterone is produced predominently in the zona glomerulosa and has been considered a major and immediate precursor of aldosterone [1, 2], an assumption based on the parallel increase in both 18-hydroxycorticosterone and aldosterone secretion in response to specific stimuli such as sodium restriction. It has, therefore, been expected that determinations of 18-hydroxycorticosterone could prove to be of considerable diagnostic value in patients with the various types of primary aldosteronism [3–7]. Indeed, increased secretion rates and plasma concentrations of 18-hydroxycorticosterone in this syndrome have been reported [4, 6]. In the present paper, three aspects of the diagnostic value of 18-hydroxycorticosterone will be analyzed: (1) Its usefulness in differentiating patients with aldosterone-producing adenomas from those with hyperaldosteronism due to adrenal hyperplasia; (2) the role of 18-hydroxycorticosterone as a possible early marker in the diagnosis of primary aldosteronism; and (3) three cases each of hypertension, elevated excretion of 18-hydroxycorticosterone but normal aldosterone levels, and adrenal adenoma will be presented.
KeywordsAdenoma Cortisol Angiotensin Dexamethasone Renin
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