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Adrenal Diagnostics: An Endocrinologist's Perspective focused on Hyperaldosteronism.
[adrenal incidentaloma]
The
era
of
sophisticated
high
resolution
imaging
with
the
consequent
identification
of
previously
unrecognised
adrenal
masses
(
adrenal
incidentalomas
)
,
has
emphasised
the
need
for
an
appropriate
biochemical
approach
to
define
adrenal
function
.
The
focus
of
this
testing
is
on
catecholamines
from
the
adrenal
medulla
(
testing
that
has
been
rendered
relatively
straightforward
by
plasma
metanephrine
measurements
)
and
the
physiological
corticosteroids
,
cortisol
and
aldosterone
,
synthesised
by
the
adrenal
cortex
.
The
diagnosis
of
hypercortisolism
remains
a
challenge
and
has
been
extensively
reviewed
.
In
the
context
of
hypertension
and
an
adrenal
incidentaloma
,
the
exclusion
of
hyperaldosteronism
has
an
importance
beyond
simple
blood
pressure
control
.
This
review
focuses
on
the
recommended
approaches
to
both
the
diagnosis
of
hyperaldosteronism
and
the
characterisation
of
its
aetiology
.
Monogenetic
causes
of
mineralocorticoid
hypertension
are
discussed
as
are
recent
developments
with
respect
to
both
the
molecular
aetiology
and
the
differential
diagnosis
of
aldosterone-producing
adenomas
.
Diseases
Validation
Diseases presenting
"hyperaldosteronism"
symptom
adrenal incidentaloma
cushing syndrome
This symptom has already been validated
