Adrenal histologic and genetic characteristics of primary aldosteronism in late adulthood
Authors' conclusion
Older individuals with lateralized PA exhibit distinct genetic and histologic causes of disease with sex differences in mutation prevalence and adrenal histopathology. In APN, the most frequently altered gene is CACNA1D, while KCNJ5 variants are most common in APA. Unlike young patients with PA, the presence of NFA is a frequent observation in late adulthood individuals with PA.
Study context
- Population
- Patients with PA who underwent unilateral adrenalectomy at age 60 or older
- Participants
- 114 patients
- Outcome
- Histopathologic subtype of adrenals
Methodological detailsCYP11B2 immunohistochemistry (IHC)-guided sequencing
- CYP11B2 IHC-guided sequencing
Main finding
As reported in the abstract
- Aldosterone-producing nodule (APN)
- 56 (49%)
- Aldosterone-producing adenoma (APA)
- 44 (39%)
- Multiple APN
- 7 (6%)
- Only non-functioning adenomas (NFA); 6 with ≥1 aldosterone-producing micronodule in adjacent tissue
- 7 (6%)
- NFA alongside APN/APA
- 24 cases
Further findings
Histologic subtype by sex
- APN most common subtype in men
- 51/88, 58%
- APA predominant in women
- 18/26, 69%
Somatic variants
- CACNA1D variants in APNs with successful sequencing
- 40/67, 60%
- KCNJ5 variants, most common alteration in APA
- 14/44, 32%
Original publication
Adrenal histologic and genetic characteristics of primary aldosteronism in late adulthood. Eur J Endocrinol. Published 31 January 2026. doi:10.
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