Possibility of normokalaemic primary aldosteronism as reflected in the frequency of adrenal cortical adenomas

Abstract

SYNOPSIS Adrenal cortical adenomas with diameters greater than 3 mm. were found in 185 (3-61 of 5,120 consecutive necropsies. A progressively higher incidence with increasing age was noted) 82 % of the adenomas occurring in cases in the age range 51-80 years.

The Prevalence of 21-Hydroxylase Deficiency in Adrenal Incidentalomas - Hormonal and Mutation Screening

“…In all patients, a careful hormonal evaluation excluded hypercortisolism, primary hyperaldosteronism, pheochromocytoma and hyperandrogenism. Based on CT characteristics, 21 patients had adrenal adenoma and 13 patients had unilateral (6) and bilateral (7) hyperplasia. In other 6 patients a CT scan suggested cysts (3 cases), myelolipoma (2 cases) and adrenocortical carcinoma (1 case), respectively.…”

“…Their incidence increases not only because of wide use of imaging techniques, but also because of aging of the population. At autopsy series the prevalence of previously undiagnosed adrenal massess ranges between 1.5 upto 8.7 % ( Devenyi et al, 1967, Hedeland et al, 1968 and large CT studies indicate a prevalence between 2 -4 % ( Abecassis et al, 1985 ). The majority of adrenal incidentalomas are benign and nonfunctioning adrenal adenomas, however recent studies demonstrate a higher occurrence of subclinical hypercortisolism ( Rossi et al, 2000, Mantero et al, 2000.…”

Localization of Steroidogenic Enzymes in Adrenal Cortex and Its Disorders.

“…A majority of these lesions are of adrenocortical origin, i.e., adrenocortical nodules and neoplasms. This finding may merely reflect the fact that nodules or neoplasms have been detected frequently at autopsies [12][13][14]. These lesions have been termed as "incidentaloma" or "non -functioning adrenocortical tumors" or "hormonally inactive adrenocortical tumors".…”

Adrenal Adenoma and Hypertension

“…On the basis of the studies of Shamma and co-workers,3) Conn has postulated that at least 20% of individuals with diagnosed essential hypertension have underlying hyperaldosteronism due to adrenocortical adnomas.12) Studies showing that one-fifth of patients with essential hypertension had an overproduction of aldosterone in the presence of low plasma renin activity strongly supported this postulate.13), 14) Other workers have found, however, that primary aldosteronism is only rarely associated with essential hypertension and that excretion of aldosterone in hypertensive patients has been found to be similar to that in normotensive individuals.15) Furthermore, autopsy studies did not indicate that 20 per cent of hypertensives had adrenal adenomas or that primary aldosteronism was the cause of their hypertension.16), 17) The presence of adrenocortical adenomas in 15.2% of hypertensives in this study is somewhat lower than in other reports,16),11) although the frequency of these tumors among all autopsied subjects (5.3%) is higher than that reported by Deveny17) and Kokko,et al16) The number of adenomas in the non-hyper-J ap. Heart J.…”