Surgical Outcomes Among Primary Aldosteronism Patients Without Visible Adrenal Lesions.

Abstract

CONTEXT:

Many patients with unilateral primary aldosteronism (PA) have normal adrenal imaging, but little is known about their outcome following adrenalectomy.

OBJECTIVE:

To evaluate biochemical and clinical outcomes after adrenalectomy in patients with unilateral PA and normal-appearing adrenal imaging.

DESIGN:

Retrospective cohort study of patients seen between January 2006 and May 2018.

SETTING:

A Canadian tertiary care PA referral center.

PATIENTS:

Consecutive individuals with PA, normal cross-sectional adrenal imaging, and lateralizing adrenal vein sampling (AVS) who underwent adrenalectomy during the study period.

PRIMARY OUTCOME:

Biochemical response to adrenalectomy graded according to the Primary Aldosteronism Surgical Outcome criteria.

RESULTS:

A total of 40 patients were included. Biochemical outcomes were available for 33 people (mean age, 54.7 years; 91% male; median follow-up, 2.7 months), with 28 (85%) showing a complete or partial response and 5 (15%) with no response. Clinical outcomes were available for 36 people (mean age, 54.6 years; 86% male; median follow-up, 9.8 months), with 31 (86%) demonstrating a complete or partial response and 5 (14%) with no response.

CONCLUSIONS:

The prognosis after adrenalectomy is highly favorable for patients with unilateral PA and normal-appearing adrenal imaging. Patients with lateralizing disease should be considered for surgery despite apparently normal adrenal imaging.

• Authors: Davis Sam, Gregory A Kline, Benny So, Janice L Pasieka, Adrian Harvey, Alex Chin, Stefan J Przybojewski, Alexander A Leung
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 106 Issue 2 Pg. e824-e835 (01 23 2021) ISSN: 1945-7197 [Electronic] United States
• PMID: 33180934 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Adrenal Glands (diagnostic imaging, pathology, surgery)
• Adrenalectomy
• Adult
• Aged
• Canada
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• Hyperaldosteronism (diagnosis, pathology, surgery)
• Male
• Middle Aged
• Postoperative Period
• Prognosis
• Retrospective Studies
• Treatment Outcome