Endocrine Abstracts

Assess the morphology of focal lesions of the adrenal glands after adrenalectomy, compare the results with the nature of the course of hypertension, the level of blood pressure, age, sex of patients.

Materials and methods: Forty-four medical maps of patients operated on for focal formations of the adrenal glands were analyzed. The clinical symptoms, the hormonal activity of adrenal gland tumors - the level of cortisol, aldosterone, potassium, sodium, renin activity of blood, metabolites of catecholamines were analyzed.

Results: Thirty-two patients (72.7%) had adrenal hypertension, 12 (27.3%) had no hypertension. In the group of patients with adrenal hypertension, women predominated - 26 (81.3%) and 6 men (18.7%), mostly of working age (50.5±5.2 years). The reason for visualization of the adrenal glands in patients with hypertension was its crisis course, resistance to antihypertensive drugs. The reason for visualization of the adrenal glands in patients without hypertension was a diverse somatic pathology. All patients underwent unilateral adrenalectomy. In 87.5% of patients with adrenal hypertension, of which women predominated (78.6%) older (53.1±3.2 years) than men (44.4±4.7 years; P<0, 05), hormonally active adrenal tumors were diagnosed: pheochromocytoma in 50%, adrenocorticosteroma and aldosteroma in 35.7% and 14.3% of cases, respectively. The remaining 12.5% had hormonally inactive adrenal formations, hence there was essential hypertension. These patients were significantly older than patients who had hormonally active adrenal formations: 65.1±2.4 and 51.5±5.1 years (P<0.05), and the blood pressure level was lower: 160/100±10/15 against 196.4/100±20/10 mm Hg. (P<0.05). The results of a histological study of adrenal removed adrenal glands in patients without hypertension revealed “dumb” tumors of chromaffin tissue in 16.7% of cases. The obtained results testify to the necessity of searching for secondary hypertension of adrenal genesis in all patients with hypertension characterized by a crisis current.

Conclusions: 1. In most cases (87.5%), the course of hypertension in patients operated on for focal formation of the adrenal gland is due to a hormone-active tumor.

2. Hormonal-active tumors of the adrenal glands in patients with a crisis course of arterial hypertension are represented in 50% of cases by pheochromocytoma, in 35.7% by adrenocorticosteroma, in 14.3% by aldosterome.

3. The creeping flow of arterial hypertension of the adrenal genesis is more often diagnosed in middle-aged women, accompanied by higher figures of arterial pressure.