Browsing by Subject "adrenalectomy"

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    Diagnosis and treatment of primary hyperaldosteronism: Review; [Primer hiperaldosteronizmin tani ve tedavisi]
    (Turkiye Klinikleri, 2007) Özmen B.; Özmen D.
    Primary hyperaldosteronism is the syndrome of excessive aldosterone secretion and concomitant suppression of the angiotensin-renin system. Its main pathophysiological features are hypertension, altered potassium homeostasis and accelerated target organ damage. Prospective studies on its prevalence around the world reveal that primary hyperaldosteronism occurs in 5-15% of patients with essential hypertension. The major causes of primary hyperaldosteronism are aldosterone-producing adenoma and bilateral idiopathic adrenal hyperplasia. Patients with hypertension and hypokalemia and most patients with treatment-resistant hypertension should be screened for primary aldosteronism with the calculation of plasma concentration to plasma renin activity ratio. The diagnosis is generally 3-tiered, involving an initial screening, confirmation of diagnosis, and determination of the specific subtype of primary hyperaldosteronism. Primary hyperaldosteronism is often refractory to conventional medical treatment. Unilateral laparoscopic adrenalectomy is an excellent treatment option for patients with unilateral aldosterone-producing- adenoma. But bilateral idiopathic hyperaldosteronism should be treated medically. Sprinolactone has been the drug of choice to treat primary hyperaldosteronism for more than three decades. The treatment goal is to prevent morbidity and mortality associated with hypertension, hypokalemia and cardiovascular damage. Copyright © 2007 by Türkiye Klinikleri.
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    Central Precocious Puberty Secondary to Adrenocortical Adenoma in a Female Child: Case Report and Review of the Literature
    (Elsevier USA, 2017) Ersoy B.; Kizilay D.; Cayirli H.; Temiz P.; Gunsar C.
    Background Pediatric adrenocortical tumors are rare but significant causes of virilization and peripheral precocious puberty (PPP). Case A 4-year-old girl presented with development of breast, pubic hair, and facial acne. Her bone age was advanced, and her gonadotropin level did not elevate in a gonadotropin-releasing hormone (GnRH) test. High levels of dehydroepiandrosterone sulfate, estradiol, and testosterone, and detection of a tumor in the left adrenal gland of the abdomen using computed tomography led to a diagnosis of PPP due to adrenal tumor. Adrenal adenoma was diagnosed with pathology after the tumor was removed. Ultrasonography detected multicystic ovaries before surgery. Although the androgen levels decreased, high estrogen levels persisted after complete tumor resection. Approximately 1 year after the surgery, the patient's breast development persisted, bone age progressed rapidly, and gonadotropin levels increased in a GnRH test. Central precocious puberty was diagnosed, and treatment with GnRH analogues was started. Summary and Conclusion Adrenal adenoma might present with isosexual PPP as well as virilization in girls. The ovaries should be carefully assessed in these patients. Prolonged exposure to androgen and estrogen might cause ovarian multicysts leading to persistence of high estrogen levels and initiation of central precocious puberty. © 2017 North American Society for Pediatric and Adolescent Gynecology