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Albert Ferro, Elizabeth Adeyeye

Original languageEnglish
Pages (from-to)30-33
Number of pages4
JournalHeart and Metabolism
Issue number79
Published1 Jan 2019

King's Authors


Primary hyperaldosteronism (PHA), also referred to as primary aldosteronism (PA), remains a largely under-recognized and suboptimally managed secondary cause of hypertension, associated with significant cardiovascular morbidity and mortality. When caused by a classical unilateral Conn's adenoma, it is potentially curable with adrenalectomy. However, identifying this remains problematic and acts as a barrier to best management. The gold-standard investigation to determine lateralization is adrenal vein sampling (AVS). This procedure is invasive and technically challenging, and results can be inconclusive. Hence, there has been much interest in finding a noninvasive yet reliable alternative to this, and the most promising candidate at present is 11C-metomidate positron emission tomography-computed tomography (PET-CT) scanning. We present the case of a patient with PHA in whom initial imaging revealed bilateral adrenal pathologies: however, after having both AVS and 11C-metomidate PET-CT which showed unilateral overproduction of aldosterone, the patient had an adrenalectomy with improvement of blood pressure. We discuss the benefits of this investigation and the potential impact it could have on managing PHA.

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