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Identifying Aldosterone-Producing Adenoma

Identifying Aldosterone-Producing Adenoma Abstract To the Editor. —I read with interest the article by Hiramatsu et al entitled "A Screening Test to Identify Aldosterone-Producing Adenoma by Measuring Plasma Renin Activity: Results in Hypertensive Patients" in the November Archives (1981;141:1589-1593).These authors showed that in the upright position, the aldosterone-plasma renin activity (PRA) ratio was always above 400 in all their hypertensive patients with aldosterone-producing adenoma (APA) and was below 200 in patients with essential hypertension. A false-positive value was also found in some of their patients with essential hypertension. The administration of diuretics and salt restriction did not increase the aldosterone-PRA ratio in their patients with essential hypertension.Using amiloride hydrochloride as a potassium-sparing diuretic, which also has an antihypertensive effect,1-3 20 to 30 mg/day for longer than eight weeks, we have examined four hypertensive patients with APA and seven patients with essential hypertension. Blood samples were obtained from the patients at 9:30 References 1. Gombos EA, Freis ED, Moghadam A: Effects of MK-870 in normal subjects and hypertensive patients. N Engl J Med 1966;275:1215-1220.Crossref 2. Kampffmeyer H, Conway J: The antihypertensive and diuretic effects of amiloride and of its combination with hydrochlorothiazide. Clin Pharmacol Ther 1968;9:350-354. 3. Kremer D, Boddy K, Brown JJ, et al: Amiloride in the treatment of primary hyperaldosteronism and essential hypertension. Clin Endocrinol 1977;7:151-157.Crossref 4. Volloton MB: Parallel radio-immunoassays of angiotensin I and of angiotensin II for measurement of renin activity and of circulating active hormone human plasma , in Levine R, Pfeifer EF (eds): Immunological Methods in Endocrinology , ed 1. New York, Academic Press Inc, 1971, pp 94-100. 5. Lijnen P, Amery A, Fagard R, et al: Direct radioimmunoassay of plasma aldosterone in normal subjects. Clin Chim Acta 1978;84:305-314.Crossref 6. Korobkin M, White EA, Kressel HY, et al: Computed tomography in the diagnosis of adrenal disease. AJR 1979;132:231-238.Crossref 7. Montagne JP, Kressel HY, Korobkin M, et al: Computed tomography of the normal adrenal glands. AJR 1978;130:963-966.Crossref 8. Brownlie K, Kreel L: Computer assisted tomography of normal suprarenal glands. J Comput Assist Tomography 1978;2:1-10.Crossref 9. Ganguly A, Melada GA, Luetcher JA, et al: Control of plasma aldosterone in primary aldosteronism: Distinction between adenoma and hyperplasia. J Clin Endocrinol Metabol 1973; 37:765-775.Crossref 10. Streeten DHP, Tomycz N, Anderson GH Jr: Reliability of screening methods for the diagnosis of primary aldosteronism. Am J Med 1979; 67:403-413.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340230221043
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —I read with interest the article by Hiramatsu et al entitled "A Screening Test to Identify Aldosterone-Producing Adenoma by Measuring Plasma Renin Activity: Results in Hypertensive Patients" in the November Archives (1981;141:1589-1593).These authors showed that in the upright position, the aldosterone-plasma renin activity (PRA) ratio was always above 400 in all their hypertensive patients with aldosterone-producing adenoma (APA) and was below 200 in patients with essential hypertension. A false-positive value was also found in some of their patients with essential hypertension. The administration of diuretics and salt restriction did not increase the aldosterone-PRA ratio in their patients with essential hypertension.Using amiloride hydrochloride as a potassium-sparing diuretic, which also has an antihypertensive effect,1-3 20 to 30 mg/day for longer than eight weeks, we have examined four hypertensive patients with APA and seven patients with essential hypertension. Blood samples were obtained from the patients at 9:30 References 1. Gombos EA, Freis ED, Moghadam A: Effects of MK-870 in normal subjects and hypertensive patients. N Engl J Med 1966;275:1215-1220.Crossref 2. Kampffmeyer H, Conway J: The antihypertensive and diuretic effects of amiloride and of its combination with hydrochlorothiazide. Clin Pharmacol Ther 1968;9:350-354. 3. Kremer D, Boddy K, Brown JJ, et al: Amiloride in the treatment of primary hyperaldosteronism and essential hypertension. Clin Endocrinol 1977;7:151-157.Crossref 4. Volloton MB: Parallel radio-immunoassays of angiotensin I and of angiotensin II for measurement of renin activity and of circulating active hormone human plasma , in Levine R, Pfeifer EF (eds): Immunological Methods in Endocrinology , ed 1. New York, Academic Press Inc, 1971, pp 94-100. 5. Lijnen P, Amery A, Fagard R, et al: Direct radioimmunoassay of plasma aldosterone in normal subjects. Clin Chim Acta 1978;84:305-314.Crossref 6. Korobkin M, White EA, Kressel HY, et al: Computed tomography in the diagnosis of adrenal disease. AJR 1979;132:231-238.Crossref 7. Montagne JP, Kressel HY, Korobkin M, et al: Computed tomography of the normal adrenal glands. AJR 1978;130:963-966.Crossref 8. Brownlie K, Kreel L: Computer assisted tomography of normal suprarenal glands. J Comput Assist Tomography 1978;2:1-10.Crossref 9. Ganguly A, Melada GA, Luetcher JA, et al: Control of plasma aldosterone in primary aldosteronism: Distinction between adenoma and hyperplasia. J Clin Endocrinol Metabol 1973; 37:765-775.Crossref 10. Streeten DHP, Tomycz N, Anderson GH Jr: Reliability of screening methods for the diagnosis of primary aldosteronism. Am J Med 1979; 67:403-413.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1982

References