Adrenal Venous Sampling in Primary Aldosteronism: The Usefulness of Contralateral Suppression Index

Joint Authors

Teixeira, Patricia de Fatima dos Santos
Treistman, Natalia
Moraes, Aline Barbosa
Cozzolino, Stéphanie
Vieira Neto, Leonardo

Source

Case Reports in Medicine

Issue

Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-4, 4 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2019-09-03

Country of Publication

Egypt

No. of Pages

4

Main Subjects

Medicine

Abstract EN

Adrenal venous sampling (AVS) is the gold standard test to differentiate the unilateral from the bilateral form in patients with primary aldosteronism (PA) although it may be a difficult procedure, especially the successful cannulation of the right adrenal vein.

In this report, we describe a 49-year-old female patient diagnosed with PA, after investigating resistant hypertension and refractory hypokalemia.

Abdominal computed tomography scan revealed a 2.5 cm adenoma on the right adrenal vein.

AVS was performed under cosyntropin infusion.

Aldosterone and cortisol concentrations were obtained from the right and left adrenal veins and inferior vena cava (IVC).

Cortisol on each adrenal vein divided by cortisol on IVC confirmed successful cannulation of the left side only, which makes it impossible to calculate the lateralization index (LI).

From the data on the left adrenal vein and IVC, the aldosterone-to-cortisol ratio divided by the IVC aldosterone-to-cortisol ratio was less than 1.0, suggesting that the left adrenal vein was suppressed with the excess aldosterone originating from the contralateral side (contralateral suppression index (CSI)).

Right adrenalectomy was performed; postoperative hypoaldosteronism was confirmed.

This report highlights the importance of CSI obtained in AVS when technical difficulties occur making it impossible to obtain LI, which is most commonly used to decide between surgical and clinical management of PA.

American Psychological Association (APA)

Treistman, Natalia& Moraes, Aline Barbosa& Cozzolino, Stéphanie& Teixeira, Patricia de Fatima dos Santos& Vieira Neto, Leonardo. 2019. Adrenal Venous Sampling in Primary Aldosteronism: The Usefulness of Contralateral Suppression Index. Case Reports in Medicine،Vol. 2019, no. 2019, pp.1-4.
https://search.emarefa.net/detail/BIM-1137231

Modern Language Association (MLA)

Treistman, Natalia…[et al.]. Adrenal Venous Sampling in Primary Aldosteronism: The Usefulness of Contralateral Suppression Index. Case Reports in Medicine No. 2019 (2019), pp.1-4.
https://search.emarefa.net/detail/BIM-1137231

American Medical Association (AMA)

Treistman, Natalia& Moraes, Aline Barbosa& Cozzolino, Stéphanie& Teixeira, Patricia de Fatima dos Santos& Vieira Neto, Leonardo. Adrenal Venous Sampling in Primary Aldosteronism: The Usefulness of Contralateral Suppression Index. Case Reports in Medicine. 2019. Vol. 2019, no. 2019, pp.1-4.
https://search.emarefa.net/detail/BIM-1137231

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1137231