The Diagnostic Value of Urinary Free 18-Hydroxycorticosterone in Primary Aldosteronism

  • S. Abdelhamid
  • P. Vecsei
  • N. Panitz
  • H. L. Christl
Conference paper
Part of the International Boehringer Mannheim Symposia book series (BOEHRINGER)


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.


Primary Aldosteronism Plasma Aldosterone Aldosterone Level Adrenal Adenoma Zona Glomerulosa 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ulick S (1976) Diagnosis and nomenclature of the disorders of the terminal portion of the aldosterone biosynthetic pathway. J Clin Endocrinol Metab 43: 92–96PubMedCrossRefGoogle Scholar
  2. 2.
    Neher R (1979) Aldosterone: chemical aspects and related enzymology. J Endocrinol 81: 25–35Google Scholar
  3. 3.
    Fraser R, Lantos CP (1978) 18-hydroxy-corticosterone: A Review. J Steroid Biochem 9: 273PubMedCrossRefGoogle Scholar
  4. 4.
    Ulick S, Nicolis GL, Vetter KK (1964) Relationship of 18-hydroxy-corticosterone to aldosterone. In: Baulieu EE, Röbel P (eds) Aldosterone. Blackwell, Oxford, pp 3–17Google Scholar
  5. 5.
    Vecsei P, Purjesz I, Wolff HP (1969) Studies on the biosynthesis of aldosterone in solitary adenoma and in nodular hyperplasia of the adrenal cortex in patients exhibiting Conn’s syndrome. Acta Endocrinol (Copenh) 62: 391–398Google Scholar
  6. 6.
    Biglieri EG, Schambelan M (1979) The significance of elevated levels of plasma 18-hydroxy-corticosterone in patients with primary aldosteronism. J Clin Endocrinol Metab 49: 87–91PubMedCrossRefGoogle Scholar
  7. 7.
    Abdelhamid S, Vecsei P, Haack D, Gless K-H, Walb D, Fiegel P, Lichtwald K (1981) Elevated “free” 18-hydroxy-corticosterone excretion as a possible indicator for early diagnosis of primary aldosteronism. J Steroid Biochem 14: 913–920PubMedCrossRefGoogle Scholar
  8. 8.
    Connolly TM, Vecsei P, Haack D, Kohl K-H, Abdelhamid S, Amenti (1978) Aldosterone diagnosis in hypertension: comparative evaluation of radioim¬-munoassays for urinary aldosterone and 18-OH-corticosterone. Klin Wochen sehr [Suppl 1] 56: 173–181Google Scholar
  9. 9.
    Vecsei P, Penke B, Joumaah A (1972) Radioimmunoassay of free aldosterone and of its 18-oxo-glucuronide in human urine. Experientia 28: 730–732Google Scholar
  10. 10.
    Kohl K-H, Vecsei P, Abdelhamid S (1978) Radioimmunoassay of tetrahydro aldosterone ( Th-Ald) in human urine. Acta Endocrinol (Copenh) 85: 596–608Google Scholar
  11. 11.
    Vecsei P, Benraad TJ, Hofmann J, Abdelhamid S, Haack D, Lichtwald K (1982) Direct radioimmunoassays for “Aldosterone” in unprocessed urine, and their use in screening to distinguish primary aldosteronism from hypertension. Clin Chem 28: 453–456PubMedGoogle Scholar
  12. 12.
    Schöneshöfer M, Fenner A, Dulce HJ (1980) Interferences in the radioim-munological determination of urinary free Cortisol. Clin Chim Acta 101: 125–130PubMedCrossRefGoogle Scholar
  13. 13.
    Ulick S, Vetter KK (1962) Identification of two C18-ocygenated corticosteroids isolated from human urine. J Biol Chem 237: 3364–3368PubMedGoogle Scholar
  14. 14.
    Beauwens R, Crabbe J, Birmingham MK (1980) Stimulation of sodium trans port by 18-hydroxydeoxycorticosterone, 18-hydeoxycorticosterone and aldosterone in the toad skin. Physiologist 23: 171Google Scholar
  15. 15.
    Huston G, Martin VI, Al-Dujaili EAS, Edwards CRW (1981) Evaluation of the mineralocorticoid activity of 18-hydroxycorticosterone. Clin Sci 61: 201–206PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1983

Authors and Affiliations

  • S. Abdelhamid
  • P. Vecsei
  • N. Panitz
  • H. L. Christl

There are no affiliations available

Personalised recommendations