Accuracy of adrenal computed tomography in predicting the unilateral subtype in young patients with hypokalaemia and elevation of aldosterone in primary aldosteronism

JPAS Study Group

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Context: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature. Objective: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone. Design and patients: We retrospectively studied 358 PA patients (n = 30, aged <35 years; n = 39, aged 35-40 years; n = 289, aged ≥40 years) with hypokalaemia and elevation of aldosterone and unilateral disease on CT who had successful AVS. Main outcome measure: Accuracy of CT findings is determined by AVS findings and/or surgical outcomes in patients aged <35 years. Results: Concordance of the diagnosis between CT and AVS was 90% (27/30) in patients aged <35 years, 79% (31/39) in patients aged 35-40 years and 69% (198/289) in those aged ≥40 years (trend for P <.01). Surgical benefit was confirmed in three patients aged <35 years and in three patients aged 35-40 years with the available surgical data who had discordance between CT and AVS findings. Collectively, the diagnostic accuracy of CT findings was 100% (30/30) if aged <35 years and 87% (34/39) if aged 35-40 years. Conclusion: Primary aldosteronism patients aged <35 years with hypokalaemia and elevation of aldosterone and unilateral disease on adrenal CT could be spared AVS.

Original languageEnglish
Pages (from-to)645-651
Number of pages7
JournalClinical Endocrinology
Volume88
Issue number5
DOIs
Publication statusPublished - May 1 2018

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Hyperaldosteronism
Hypokalemia
Aldosterone
Tomography
Veins
Adrenalectomy
Outcome Assessment (Health Care)
Guidelines

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{0a450498d2bf471d83f0cf94089f4a55,
title = "Accuracy of adrenal computed tomography in predicting the unilateral subtype in young patients with hypokalaemia and elevation of aldosterone in primary aldosteronism",
abstract = "Context: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature. Objective: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone. Design and patients: We retrospectively studied 358 PA patients (n = 30, aged <35 years; n = 39, aged 35-40 years; n = 289, aged ≥40 years) with hypokalaemia and elevation of aldosterone and unilateral disease on CT who had successful AVS. Main outcome measure: Accuracy of CT findings is determined by AVS findings and/or surgical outcomes in patients aged <35 years. Results: Concordance of the diagnosis between CT and AVS was 90{\%} (27/30) in patients aged <35 years, 79{\%} (31/39) in patients aged 35-40 years and 69{\%} (198/289) in those aged ≥40 years (trend for P <.01). Surgical benefit was confirmed in three patients aged <35 years and in three patients aged 35-40 years with the available surgical data who had discordance between CT and AVS findings. Collectively, the diagnostic accuracy of CT findings was 100{\%} (30/30) if aged <35 years and 87{\%} (34/39) if aged 35-40 years. Conclusion: Primary aldosteronism patients aged <35 years with hypokalaemia and elevation of aldosterone and unilateral disease on adrenal CT could be spared AVS.",
author = "{JPAS Study Group} and Hironobu Umakoshi and Tatsuki Ogasawara and Yoshiyu Takeda and Isao Kurihara and Hiroshi Itoh and Takuyuki Katabami and Takamasa Ichijo and Norio Wada and Yui Shibayama and Takanobu Yoshimoto and Yoshihiro Ogawa and Yoshihiro Ogawa and Masakatsu Sone and Nobuya Inagaki and Katsutoshi Takahashi and Minemori Watanabe and Yuichi Matsuda and Hiroki Kobayashi and Hirotaka Shibata and Kohei Kamemura and Michio Otsuki and Yuichi Fujii and Koichi Yamamto and Atsushi Ogo and Toshihiko Yanase and Shintaro Okamura and Shozo Miyauchi and Tomoko Suzuki and Mika Tsuiki and Mitsuhide Naruse",
year = "2018",
month = "5",
day = "1",
doi = "10.1111/cen.13582",
language = "English",
volume = "88",
pages = "645--651",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Accuracy of adrenal computed tomography in predicting the unilateral subtype in young patients with hypokalaemia and elevation of aldosterone in primary aldosteronism

AU - JPAS Study Group

AU - Umakoshi, Hironobu

AU - Ogasawara, Tatsuki

AU - Takeda, Yoshiyu

AU - Kurihara, Isao

AU - Itoh, Hiroshi

AU - Katabami, Takuyuki

AU - Ichijo, Takamasa

AU - Wada, Norio

AU - Shibayama, Yui

AU - Yoshimoto, Takanobu

AU - Ogawa, Yoshihiro

AU - Ogawa, Yoshihiro

AU - Sone, Masakatsu

AU - Inagaki, Nobuya

AU - Takahashi, Katsutoshi

AU - Watanabe, Minemori

AU - Matsuda, Yuichi

AU - Kobayashi, Hiroki

AU - Shibata, Hirotaka

AU - Kamemura, Kohei

AU - Otsuki, Michio

AU - Fujii, Yuichi

AU - Yamamto, Koichi

AU - Ogo, Atsushi

AU - Yanase, Toshihiko

AU - Okamura, Shintaro

AU - Miyauchi, Shozo

AU - Suzuki, Tomoko

AU - Tsuiki, Mika

AU - Naruse, Mitsuhide

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Context: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature. Objective: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone. Design and patients: We retrospectively studied 358 PA patients (n = 30, aged <35 years; n = 39, aged 35-40 years; n = 289, aged ≥40 years) with hypokalaemia and elevation of aldosterone and unilateral disease on CT who had successful AVS. Main outcome measure: Accuracy of CT findings is determined by AVS findings and/or surgical outcomes in patients aged <35 years. Results: Concordance of the diagnosis between CT and AVS was 90% (27/30) in patients aged <35 years, 79% (31/39) in patients aged 35-40 years and 69% (198/289) in those aged ≥40 years (trend for P <.01). Surgical benefit was confirmed in three patients aged <35 years and in three patients aged 35-40 years with the available surgical data who had discordance between CT and AVS findings. Collectively, the diagnostic accuracy of CT findings was 100% (30/30) if aged <35 years and 87% (34/39) if aged 35-40 years. Conclusion: Primary aldosteronism patients aged <35 years with hypokalaemia and elevation of aldosterone and unilateral disease on adrenal CT could be spared AVS.

AB - Context: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature. Objective: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone. Design and patients: We retrospectively studied 358 PA patients (n = 30, aged <35 years; n = 39, aged 35-40 years; n = 289, aged ≥40 years) with hypokalaemia and elevation of aldosterone and unilateral disease on CT who had successful AVS. Main outcome measure: Accuracy of CT findings is determined by AVS findings and/or surgical outcomes in patients aged <35 years. Results: Concordance of the diagnosis between CT and AVS was 90% (27/30) in patients aged <35 years, 79% (31/39) in patients aged 35-40 years and 69% (198/289) in those aged ≥40 years (trend for P <.01). Surgical benefit was confirmed in three patients aged <35 years and in three patients aged 35-40 years with the available surgical data who had discordance between CT and AVS findings. Collectively, the diagnostic accuracy of CT findings was 100% (30/30) if aged <35 years and 87% (34/39) if aged 35-40 years. Conclusion: Primary aldosteronism patients aged <35 years with hypokalaemia and elevation of aldosterone and unilateral disease on adrenal CT could be spared AVS.

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U2 - 10.1111/cen.13582

DO - 10.1111/cen.13582

M3 - Article

C2 - 29464741

AN - SCOPUS:85043570075

VL - 88

SP - 645

EP - 651

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 5

ER -