## It is a curious conundrum when adrenal venous sampling (AVS) is performed in a patient with primary aldosteronism (PA) and the aldosterone concentrations from both successfully sampled adrenal veins…

## Establishing corticotropin (ACTH) dependence is a crucial step in the diagnostic evaluation of hypercortisolism and relies on measurement of ACTH. In ACTH-dependent hypercortisolism, pituitary magnetic resonance imaging (MRI) is…

## Workup for corticotropin (ACTH)-independent hypercortisolism is required in any patient with an adrenal mass, regardless of symptoms of hormone excess. Adrenalectomy is the treatment of choice for a unilateral…

## Adrenal venous sampling (AVS) is technically demanding. The success rate of sampling both adrenal veins is ≈95% at centers of excellence. However, at medical centers with low AVS case…

## Mineralocorticoid receptor antagonists (MRAs) (e.g., spironolactone and eplerenone) prevent aldosterone from activating the receptor, resulting, sequentially, in sodium loss, a decrease in plasma volume, and an elevation in renin….

## Unlike aldosterone-producing adenomas (APAs) that can be <1 cm in diameter and cause the full syndrome of primary aldosteronism (PA), clinically important cortisol-secreting adenomas require a “big factory” (e.g.,…

## Bilateral macronodular adrenal hyperplasia (BMAH) is typically a computed tomography (CT)-based diagnosis. When patients present with primary aldosteronism (PA) and BMAH is found on the CT scan, the aldosterone…

## There are six subtypes of primary aldosteronism (PA). The most common subtype of PA is bilateral idiopathic adrenal hyperplasia (IHA) (≈60% of patients) (see Case 8). The second most…

## The differential diagnosis in a patient with primary aldosteronism (PA) when bilateral adrenocortical nodules are found on adrenal computed tomography (CT) scan includes bilateral idiopathic nodular hyperplasia, bilateral aldosterone-producing…

## Cross-sectional computed imaging lacks the necessary accuracy to determine if a patient has unilateral adrenal versus bilateral adrenal disease as the cause of primary aldosteronism (PA). If abdominal computed…