Adrenal Venous Sampling (AVS) is Essential for Detecting Unilateral or Bilateral Adrenal Lesions in Primary Aldosteronism

摘要

Minami et al. have reported in the recent issue of Endocrine Journal that adrenal venous sampling (AVS) is unnecessary before surgical treatment for unilateral adrenalectomy in a hypertensive patient with primary aldosteronism (PA) with presence of unilateral adrenal tumor detected by CT, who is younger than 52 years old demonstrating hypokalemia (<3.4mEg/l) with less than 1.45-fold increase in PAC after furosemide stimulation (Criteria III), after examining the clinical characteristics of 35 cases who were definitely diagnosed as PA [1]. They emphasized that AVS is an invasive method, and that the unilateral lesion found by CT images is a real mass, which would induce hyperaldosteronemia in such cases. At the 30th annual scientific meeting of the Japanese Society of Hypertension (2007), they reported that AVS is unnecessary in cases with PAC>15.0 ng/dl and which had less than 2.0-fold increase in PAC after furosemide stimulation by analyzing 22 cases of PA (Criteria I).