PROHORMONES IN ADRENAL VENOUS EFFLUENT IN PATIENTS WITH PRIMARY HYPERALDOSTERONISM

Aldosterone-producing adenoma (APA) and idiopathic hyperplasia (IHA) a re two main causes of primary hyperaldosteronism, which differ in the modes of treatment. Some of the prohormones, such as 18-hydroxycortico sterone, are elevated in adenomas. 19-Nor-deoxycorticosterone (19-nor- DOC), produced in the kidney, has been shown to be excreted in excess in patients with APA. Deoxycorticosterone is a known precursor of aldo sterone and 19-nor-DOC. This study is designed to evaluate the levels of prohormones in adrenal venous effluent in eight patients, three wit h APA, of which two were confirmed by surgical pathology and four with IHA, and one patient with primary adrenal hyperplasia. 19-OH-DOC, a p recursor of 19-nor-DOC, was found to be the main prohormone in adrenal venous effluent in patients with both APA and IHA. 19-Oic-deoxycortic osterone and 19-nor-DOC were also detected, but in smaller quantities. 19-OH-DOC appears to be the main prohormone in adrenal venous effluen t for the biosynthesis of 19-nor-DOC.