Aldosteroma is a benign growth of the adrenal medulla that produces the hormonal agent aldosterone. Causes the advancement of a condition called Connes syndrome.
Aldosterone is a hormonal agent that assists the body keep fluid throughout dehydration. When its production is increased, clients normally suffer hypertension. This pathology is 3 times more typical in ladies than in guys, at the age of 30-50 years. In unusual cases, the growth likewise impacts kids.
Aldosteroma can be single and numerous, be both unilateral and bilateral. As a guideline, this is a growth with a little size (no greater than 3 cm), having a yellow-brown tint and a pill of connective tissue structures.
Malignant forms represent 5% of all cases; they are formed from the adrenal cortex’s own tissues. These growths proliferate and can metastasize to other organs and systems.
Causes of look
The etiology of aldosteroma is unidentified, however lots of scientists think that the primary reason for adrenal growth advancement is a strained genetic history.
The primary possible causes are:
- Hereditary predisposition.
- Taking high dosages of glucocorticoids.
- Previous surgical treatment on the pituitary gland or adrenal glands.
- Stressful circumstances.
- Idiopathic etiology (when the cause is unidentified).
It is likewise required to consider the function of danger elements:
- Age over 30 years.
- Smoking, drinking alcohol.
- Hypertonic illness.
- Polycystic ovary.
- Lipid metabolic process conditions.
A growth of the left adrenal gland is more typical than the ideal one.
The primary medical indications are:
- Increase in high blood pressure to high numbers.
- Persistent high blood pressure (requirement to take numerous medications to manage high blood pressure).
- Hypokalemia, which causes the advancement of seizures, polydipsia, polyuria, palpitations.
- Rhythm and conduction disruptions appear due to fluid and salt retention.
- Pain in the stomach.
- Hyperthermia and other symptoms of intoxication in the deadly nature of the procedure.
- Pain in the adrenal glands (with big growths).
And just 10% do disappoint themselves with aldoster, continuing asymptomatically.
When making a medical diagnosis, attention is paid to the client’s grievances: unchecked high blood pressure, disturbances in the work of the heart, convulsions, weak point, etc. As with any illness, obligatory and extra research study approaches are needed.
Mandatory study approaches:
- AS (medical blood test): in many cases, within regular limitations, however in some cases leukocytosis, sped up ESR can be observed, which suggests the collapse of the deadly growth.
- General urine analysis without pathology.
- 24-hour urinary aldosterone excretion test (increased).
- Biochemical blood test for aldosterone (increased) and renin (reduced), potassium (<, 3.3 mmol/l).
- Captopril test: The patient is given a single dose of this drug and blood levels of aldosterone and renin are measured. In patients with primary hyperaldosteronism, hormone levels remain the same as before the study.
Instrumental examination methods:
- Ultrasound of the abdominal organs, kidneys and adrenal glands: helps to make differential diagnosis with other diseases and to identify tumor-like formation.
- CT, MRI are more informative research methods, they will help to distinguish a benign process from a malignant one.
- Angiography is not very informative, since most aldosteromas are small and have poor blood supply.
- Aspiration biopsy with further histological examination for cell atypia.
The main method of treatment with aldoster is surgery. Before the operation, it is necessary to perform a CT or MRI scan in order to determine the amount of permissible intervention. In some cases, it will be enough to remove only the tumor, in others – the entire adrenal gland.
The operation of choice is unilateral laparoscopic adrenalectomy. It should be offered to all patients with documented unilateral aldosteroma.
If the patient refuses surgery or he has serious contraindications for surgical treatment, then conservative therapy is prescribed.
A good effect is provided by food with an increased intake of salt and foods rich in potassium (seaweed, prunes, raisins, beans, oatmeal, etc.). In parallel, potassium preparations (Asparkam) can be prescribed.
Of the antihypertensive drugs, potassium-sparing diuretics are most preferred:
- Spironolactone tab. 25 mg once a day – the initial dose, if necessary, selected individually for each patient.
- Veroshpiron tab. 25 mg once a day.
For hormonal correction, glucocorticoids are prescribed:
Consequences and complications
High blood pressure can complicate the functioning of the heart and kidneys, which can lead to:
- Heart attack.
- Chronic heart failure.
- Left ventricular hypertrophy (enlargement of the heart chamber).
- Acute or chronic renal failure.
- Coronary artery disease.
- Premature death.
With timely treatment started, the prognosis of the disease is favorable. But if complications develop in other organs, the percentage of a favorable outcome decreases. In malignant tumors, the prognosis is usually poor.
To prevent the development of a tumor, it is recommended:
- Avoid emotional stress, physical stress, hypothermia.
- Limit the consumption of table salt to 3 g per day.
- Observe the mode of work and rest.
- Control body weight, do not overeat.
- Take daily walks in the fresh air.
- Do not take glucorticoid medications without a doctor’s prescription.
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