ABSTRACT
The authors discuss the results of observation of 269 patients with adrenal arterial hypertension 247 of whom underwent operation. The malignant hypertension syndrome developed in 39% of the patients. It is presumed that its development was caused by the combination of adrenal and renal affections as well as by specific hormonal shifts: relative norepinephrine hyperproduction and reduced intensity of catecholamine metabolism. In all groups of the patients with the malignant hypertension syndrome, a higher daily excretion of aldosterone and increased blood renin activity were also found. The character of the drug therapy and the late results of surgical treatment are discussed. A new variant of hyperaldosteronism, dexamethasone-inhibited form of aldosteroma, is described.
Subject(s)
Adrenal Gland Diseases/complications , Hypertension/etiology , Adrenal Gland Diseases/mortality , Adrenal Gland Diseases/surgery , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/mortality , Adrenal Gland Neoplasms/surgery , Adrenalectomy , Adult , Chronic Disease , Female , Humans , Hypertension/mortality , Hypertension/surgery , Hypertension, Malignant/etiology , Hypertension, Malignant/mortality , Hypertension, Malignant/surgery , Male , Middle AgedABSTRACT
In 15% of patients with Conn's syndrome the tumor may be bilateral. The topical diagnosis of a bilateral lesion is very complicated. These difficulties depend, as a rule, on the difference in the size of the tumor. Under such conditions the discovery of a larger tumor of one of the adrenals allows a pathological condition to be ruled out on the other side. From their personal experience the authors show the difficulty of the diagnosis of bilateral aldosteromas and offer an appraisal of the scintigraphic method of examination in a bilateral lesion. It is suggested that in bilateral adrenal tumours the accumulation of the radio pharmacological agent in the tumours is in inverse proportion to the term of tumour development, which is confirmed by the result of scanning conducted in dynamics in one patient.
Subject(s)
Adrenal Gland Neoplasms/pathology , Hyperaldosteronism/pathology , Neoplasms, Multiple Primary/pathology , Adrenal Gland Neoplasms/metabolism , Aldosterone/metabolism , Female , Humans , Male , Middle Aged , Neoplasms, Multiple Primary/metabolismSubject(s)
Hyperaldosteronism/diagnosis , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/surgery , Adult , Female , Humans , Hyperaldosteronism/pathology , Hyperaldosteronism/surgery , Hypokalemia/diagnosis , Male , Middle Aged , Retrospective StudiesSubject(s)
Adrenal Gland Neoplasms/surgery , Cushing Syndrome/surgery , Hypertension/therapy , Pheochromocytoma/surgery , Adolescent , Adrenalectomy/methods , Adult , Aged , Female , Humans , Hypertension/etiology , Male , Middle AgedSubject(s)
Glomerulonephritis/complications , Hyperaldosteronism/etiology , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/diagnosis , Adult , Aldosterone/metabolism , Chronic Disease , Edema/complications , Female , Humans , Hypertension/etiology , Paraneoplastic Endocrine Syndromes/complicationsABSTRACT
The author observed 230 patients with hormone-active tumor of the adrenal attended with arterial hypertension. In 90 patients there were concomitant hypertensive diseases of the kidneys. The diagnosis of the concomitant disease was verified during roentgenography, aortography included. In 66 of 90 patients (73.3%) arterial hypertension followed a malignant course. The presence of adrenal tumor was verified morphologically after the operation in 208 patients and during autopsy in 22. The concomitant renal disease was confirmed histologically on autopsy in 7 fatal cases and by kidney biopsy in 36. The clinical characteristics of the variants of combined lesions of the kidneys and adrenals and the methods of their diagnosis are discussed. The author recommends examining the adrenals in all patients suffering from malignant arterial hypertension.
