Horm Metab Res 2010; 42(6): 374-381
DOI: 10.1055/s-0029-1243619
Review

© Georg Thieme Verlag KG Stuttgart · New York

Progress in Primary Aldosteronism: Present Challenges and Perspectives

C. E. Gomez-Sanchez1 , G. P. Rossi2 , F. Fallo3 , M. Mannelli4
  • 1Division of Endocrinology, G. V. (Sonny) Montgomery VA Medical Center and University of Mississippi Medical Center, Jackson, USA
  • 2DMCS-Internal Medicine 4, University Hospital, Padova, Padova, Italy
  • 3Department of Medical and Surgical Sciences, University of Padova, Padova, Italy
  • 4Department of Clinical Pathophysiology, University of Florence, Florence, Italy
Further Information

Publication History

received 30.10.2009

accepted 01.12.2009

Publication Date:
20 January 2010 (online)

Abstract

Primary Aldosteronism (PA) is a disorder of the adrenal zona glomerulosa (ZG) in which aldosterone secretion is increased and is relatively autonomous of normal regulatory mechanisms. A recent conference in Munich organized by Prof. Reincke addressed advances and challenges related to the screening, diagnosis, and identification of uni- and bilateral involvement of the diseased adrenal of PA. Some infrequently addressed issues are described herein. We postulate that most cases of PA are due to the activation by unknown mechanisms of subset of cells resulting in the formation of a multiple foci or nodules of hyperactive zona glomerulosa cells. This implies that one or several yet unidentified stimuli can drive aldosterone overproduction, as well as the proliferation of aldosterone-producing cells. Current diagnostic procedures allow to determine whether inappropriate aldosterone production is driven by one or both adrenal glands and thus to establish optimal treatment.

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Correspondence

C. E. Gomez-SanchezMD 

Division of Endocrinology G.V. (Sonny)

Montgomery VA Medical Center

1500 E Woodrow Wilson Drive

MS 39216 Jackson

USA

Phone: +1 601 368 3844

Fax: +1 601 364 1236

Email: cgomez-sanchez@medicine.umsmed.edu