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1 . 2021

Еxperience of using selective blood sampling from the adrenal veins in a patient with primary hyperaldosteronism: a clinical case

Abstract

Primary hyperaldosteronism is one of the most common causes of secondary hypertension. In this disease, the source of increased aldosterone levels is tumor or hyperplastic changes in the glomerular zone of the adrenal cortex. The development of primary hyperaldosteronism can be caused by: aldosterone-producing adrenal adenoma, unilateral or bilateral adrenal hyperplasia, hereditary primary hyperaldosteronism, adrenocortical cancer.

The aldosterone/renin ratio is currently a reliable and affordable screening method for primary hyperaldosteronism. A more accurate diagnosis of primary hyperaldosteronism is carried out with the help of stress tests. To visualize the formations of the adrenal glands, a computed tomography of the adrenal glands is used. The results obtained are analyzed in combination with comparative selective blood sampling from the adrenal veins, which allows differentiating unilateral and bilateral adrenal lesions.

This article describes the experience of using comparative selective blood sampling from the adrenal veins in a patient with proven primary hyperaldosteronism. Performing a comparative selective blood sampling from the adrenal veins seems appropriate in complex clinical cases in patients with bilateral adrenal lesions. However, the technique is technically difficult: in most cases, catheterization of the right adrenal vein is unsuccessful and interpretation of the results of the study is extremely difficult.

Keywords:hyperaldosteronism, comparative selective blood sampling, adrenal gland formation

Funding. The work was carried out within the framework of state budget funding.

Conflict of interests. The authors declare no conflicts of interest.

For citation: Volkova A.R., Mozgunova V.S., Lisker A.V., Ostroukhova E.N., Arefyeva A.N. Еxperience of using selective blood sampling from the adrenal veins in a patient with primary hyperaldosteronism: a clinical case. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2021; 10 (1): 88-92. DOI: https://doi.org/10.33029/2304-9529-2021-10-1-88-92 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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