Immunohistochemical staining seems mandatory for individualizing and shortening follow‐up in unilateral primary aldosteronism
Authors' conclusion
We found IHC mandatory for accurate histopathologic diagnosis of PA. Our results support the importance of contralateral suppression when interpreting AVS results. Also, the study highlights the complicated assessment of clinical outcome and importance of aldosterone and renin measurements during follow-up.
Study context
- Population
- All patients with unilateral primary aldosteronism (PA) diagnosed in Iceland in 2007–2016 who underwent adrenalectomy, aged 28–73 years
- Participants
- 26 patients
- Exposure
- Aldosterone-producing nodule vs Aldosterone-producing adenoma vs Multiple aldosterone-producing micronodules
- Aldosterone-producing nodulen = 12
- Aldosterone-producing adenoman = 10
- Multiple aldosterone-producing micronodulesn = four
- Outcome
- Long-term clinical outcomes (PASO criteria) by IHC classification
Methodological detailssingle tertiary referral centre, up to 16 years follow-up, HISTALDO consensus classification, PASO criteria
- Single tertiary referral centre
- Up to 16 years follow-up
- HISTALDO consensus classification
- PASO criteria
Main finding
As reported in the abstract
Immunohistochemistry (IHC) altered histopathology from previous H&E diagnosis
23%
6/26
Partial clinical success
81%
21/26
Complete clinical success at 12 months post-op with severe relapse later
1 of 5
Observational data: associations, not effects.
Further findings
| Outcome | Median | P value |
|---|---|---|
| AVS lateralization index, classical group vs otherHigher in the classical group | 10.1 vs. 5.3 | P = 0.04 |
| AVS contralateral suppression (nondominant ratio), classical group vs otherMore contralateral suppression in the classical group | 0.4 vs. 1.0 | P = 0.03 |
Potassium supplementation during follow-up
- Needed potassium supplementation
- 8% (2/26)
Original publication
Immunohistochemical staining seems mandatory for individualizing and shortening follow‐up in unilateral primary aldosteronism. Clin Endocrinol (Oxf). Published 31 July 2023. doi:10.
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