Primary hyperaldosteronism with concomitant cortisol secretion

Abstract

Objectives - is to determine the occurrence of combined autonomous cortisol secretion among patients with primary hyperaldosteronism, to study the hormonal profile of these patients and the diagnostic capabilities of comparative selective sampling of venous blood from the central vein of the adrenal gland and the risks of developing adrenal insufficiency in the postoperative period. Material and methods: the study included 7 patients with primary hyperaldosteronism with combined autonomous secretion of cortisol who were treated in the clinic from 2010 to 2019. Results: Autonomic secretion of cortisol was diagnosed in 9,7% of patients with primary hyperaldosteronism. The frequency of discrepancy between the intrascopic picture and comparative selective blood sampling in patients with combined autonomous aldosterone-cortisol secretion was 57,1%. Performing comparative selective blood sampling in patients with Conning syndrome makes it possible to establish the side of hyperproduction of aldosterone and cortisol in bilateral adrenal adenoma with unilateral hormone production. Postoperative adrenal insufficiency was observed in 28,6% of patients with Conning syndrome. Mixed adrenal adenomas can be a source of joint hypersecretion of aldosterone and cortisol. Conclusions: For all patients with primary hyperaldosteronism, it is necessary to exclude joint autonomous production of cortisol, which allows for a correct assessment of the results of comparative selective blood sampling, choice of treatment and prediction of the risk of developing postoperative adrenal insufficiency.