Do you forgo adrenal imaging in a patient with primary hyperaldosteronism who has decided against surgery?
Do you have any concerns about missing an adrenal carcinoma if imaging is not pursued?
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Do you have concerns about missing an adrenal carcinoma if adrenal imaging is not pursued in a patient with primary hyperaldosteronism who has decided against surgery?
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3 Answers
Mednet MemberInvited Expert
Endocrinology · University of Missouri School of Medicine
Answered on
Yes. It would be a waste of time and money. Can go straight to using spironolactone or other mineralocorticoid blocker.
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Mednet MemberInvited Expert
Endocrinology · Johns Hopkins Department Of Endocrinology Diabetes And Metabolism
Answered on
I agree with the new Endocrine Society guidelines on pursuing adrenal imaging if AVS and surgery are planned. In my opinion, the yield of finding a significant adrenal pathology that will change management in a patient with suspected PA who does not desire surgery is extremely low.
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Mednet Member
Nephrology · Ascension Borgess Health
Answered on · Updated on
Starting an aldosterone blocker would be prudent in such cases and save money on imaging.
Addendum: Reassurance that no imaging is an acceptable standard of care.
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