Diagnosis and treatment of aldosterone-producing adenoma in a young patient: a clinical case

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Abstract

The prevalence of primary hyperaldosteronism (PHA) among individuals with essential arterial hypertension is about 5 to 10%. We present a clinical case of a 32 year old male patient, who despite the full clinical picture of PHA, was managed in primary care setting with the diagnosis of myalgia and treatment-resistant arterial hypertension. The article discusses clinical and laboratory parameters of the patient with the diagnosis of unilateral aldosteroma and the efficacy of its treatment. The generally accepted algorithm of PHA diagnosis with unilateral aldosterone-producing adenoma in young patients does not involve comparative selective blood sampling from adrenal veins. This accelerates the differential diagnosis and facilitates the decision to undertake surgery. This simplified diagnostic algorithm was successfully applied in the patient. Reasonable surgical intervention has led to the recovery of the patient. Awareness of various medical specialties of the up-to-date information on PHA and wide implementation of its screening into clinical practice, first of all, assessment of aldosterone-renin ratio, would allow for detection of the disease as early as possible and prevention of the development of life-threatening cardiovascular complications.

About the authors

L. Yu. Khamnueva

Irkutsk State Medical University

Author for correspondence.
Email: hamnueval@mail.ru
ORCID iD: 0000-0001-6296-898X

Larisa Yu. Khamnueva – MD, PhD, Professor, Head of the Chair of Endocrinology, Clinical Pharmacology and Immunology

1 Krasnogo Vosstaniya ul., Irkutsk, 664003

Russian Federation

L. S. Andreeva

Irkutsk State Medical University

Email: andreeva_larisa_@mail.ru
ORCID iD: 0000-0003-4687-0004

Larisa S. Andreeva – MD, PhD, Associate Professor, Chair of Endocrinology, Clinical Pharmacology and Immunology

1 Krasnogo Vosstaniya ul., Irkutsk, 664003

Russian Federation

N. P. Tokareva

Irkutsk Regional Сlinical Hospital

Email: n.p_tokareva@mail.ru

Natalya P. Tokareva – MD, Endocrinologist, Department of Endocrinology

100 Yubileyny mikrorayon, Irkutsk, 664049

Russian Federation

A. V. Novozhilov

Irkutsk State Medical University;
Irkutsk Regional Сlinical Hospital

Email: novojilov_av@mail.ru
ORCID iD: 0000-0003-1957-287X

Alexandr V. Novozhilov – MD, PhD, Associate Professor, Chair of Hospital Surgery Irkutsk State Medical University; Head of the Department of Portal Hypertension Irkutsk Regional Сlinical Hospital

1 Krasnogo Vosstaniya ul., Irkutsk, 664003;

100 Yubileyny mikrorayon, Irkutsk, 664049

Russian Federation

A. A. Efimov

Irkutsk Regional Сlinical Hospital

Email: efim_@mail.ru

Andrey A. Efimov – Head of the Department of Radiation Diagnostics

100 Yubileyny mikrorayon, Irkutsk, 664049

Russian Federation

E. V. Rozhanskaya

Irkutsk Regional Pathological Bureau

Email: rozha1974@mail.ru

Elena V. Rozhanskaya – MD, Pathologist

100–17 Yubileyny mikrorayon, Irkutsk, 664049

Russian Federation

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Copyright (c) 2021 Khamnueva L.Y., Andreeva L.S., Tokareva N.P., Novozhilov A.V., Efimov A.A., Rozhanskaya E.V.

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