Endocrine Abstracts

Introduction: Aldosterone-producing adenoma (APA) in adrenals is relatively rare but diagnostically the most complex hormonal active formation in adrenals. Difficulty of APA diagnostics is that clinically these states are hardly distinguishable from essential hypertonic disease. Besides, it is difficult to differentiate them from several symptomatic arterial hypertensions (AH), such as nephrogenic AH, some types of vascular AH or continuous and mixed pheochromocytoma.

The objective of the research was to study clinical aging characteristics of APA.

Materials and methods. Among the studied patients with various formations in adrenals (n = 282), who received out-patient and in-patient treatment in the Republican Specialized Scientific Practical Medical Center of Endocrinology of the Uzbekistan Public Healthcare Ministry within the period from 2000 to 2018, there were 16 patients with APA (5.6%). Among them there were 11(68.8%) women and 5(31.2%) men. The age of patients varied from 20 to 65 years old, with the average age 42.4 ± 12.4 years old. All patients had common clinical, biochemical, and instrumental tests.

Results: Majority of the patients (68.8%) with APA were young workable people, while 18.8% and 12.4% were people of middle and old age, respectively. in relation to gender distribution, APA was 3 times more often observed in female patients. Leading clinical manifestation in all patients with APA in 100% of the cases was AH, which was constant in 75% of the patients, mixed in 12.5%, and in 12.5% of the cases it had constant malignant character. It should be noted, that most often registered among the patients with APA was AH stage I (50%) and AH stage II (37.5%), while only 12.5% had AH stage III. AP values varied from 130/90 to 240/140 mmHg. Maximal level of SAP varied from 160 to 240 mmHg (average value 186.3 ± 28.3 mmHg), DAP from 100 to 140 mmHg (average 111.9 ± 14.7 mmHg). In our observations classical clinical triad including combination of three basic syndromes (AH, neuromuscular, and renal) was noted only in 62.5% of the patients with APA.

Conclusion: Thus, summarizing the obtained data, it can be concluded that, APA was more often met in young workable age with higher prevalence rate among women. Leading clinical manifestation in all patients with APA was AH. It should be noted that, combination of AH, especially in young people, and familiar history of AH and its complications in the closest relatives should serve to be the basis for exclusion of APA diagnosis.