APAとIHAの頻度(第3回副腎静脈サンプリング研究会プロシーディングス)

概要

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Hypertension caused by primary aldosteronism (PA) due to aldosterone-producing adenoma (APA) is curable by surgically removing the lesion. Differential diagnosis of APA from idiopathic hyperaldosteronism (IHA) is critical before a clinician can decide how to treat each of the condition, since APA is treated by resection of the adrenal lesion while IHA is treated by administration of aldosterone blockades. Clinical records of 65 PA patients, who visited our hospitals from 1995 to 1999, were analyzed. They were confirmed as having PA by endocrinological examinations such as upright posture furosemide test and captopril loading. Differential diagnosis of APA from IHA by CT and ACTH-loaded adrenal venous sampling (AVS) was performed. The incidences of IHA and APA were 19 and 74%, respectively among 65 patients with PA. Our data suggested that surgically curable hypertension caused by PA due to APA is the commonest type among various forms of PA. We, therefore, should accurately diagnose APA, of which laterality of hyperaldosterone production is only detectable by AVS, and should clearly differentiate APA from IHA.
東京女子医科大学の論文