Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2008) 15 OC20

SFEBES2008 Oral Communications Tumours, diabetes, bone (8 abstracts)

Serum 18 hydroxycortisol identifies aldosteronoma in the differential diagnosis of primary aldosteronism

Sowmya Narasimhan 1,2 , Alan McGregor 1,2 , John Miell 1,2 , Susan Mary Chambers 1,2 , Hagosa Demoz Abraha (Daines) 1,2 & Simon Aylwin 1,2


1King’s College Hospital, London, UK; 2University Hospital Lewisham, London, UK.


Introduction: 18-hydroxycortisol (18-OHF) is known to be elevated in glucocorticoid remediable aldosteronism but there are few data relating to 18-OHF in the differential diagnosis of primary aldosteronism.

Aim: We evaluated the usefulness of lying and standing 18-OHF in patients with primary aldosteronism in differentiating between aldosteronoma, bilateral adrenal hyperplasia (BAH) and normality.

Methods: Patients (n=27) with an elevated aldosterone renin ratio (ARR) were further evaluated by assessing lying and standing aldosterone, renin, cortisol and 18-OHF after salt loading. 18-OHF levels (in house flouro-immuno assay, Delfia method) were compared according to adenoma (histological confirmation), BAH (no lesion on imaging with consistent biochemistry) and normality (normalisation of ARR after salt loading).

Results: All data given as mean (range).

Aldosteronoma (n=9)BAH (n=12)Normal ARR (n=6)
Mean 18-OHF (nmol/l) lying10.4 (4.1–21.1)4.2 (2.1–6.4)2.6 (2.0–3.7)
Mean 18-OHF (nmol/l) standing12.5 (8.4–22.8)5 (2.3–7.3)4 (2.6–6.2)

Recumbent 18-OHF levels were greater in adenomas than patients with hyperplasia (P≤0.001) and patients with normal ARR (P−<0.01) This was even more clear cut with standing 18-OHF where there was no overlap between adenoma and BAH (P≤0.001).

Conclusion: Although a sub centimetre angiotensin 2 sensitive adenoma might be classified as BAH in our data, 18-OHF is a potentially valuable tool in discriminating adenoma from hyperplasia.

Article tools

My recent searches

No recent searches.