Incidentaloma screening: Difference between revisions

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Revision as of 21:17, 5 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes: family screening for patients with bilateral macronodular hyperplasia, patients with asymptomatic vertebral fractures, patients with possible autonomous cortisol secretion, patients with a hereditary syndrome leading to adrenal tumors. Screening test include 24-hour urine fractionated metanephrines for pheochromocytoma, 24-hour urinary free cortisol for patients with symptoms of Cushing's syndrome, and Plasma aldosterone concentration, plasma renin activity for patients with Primary aldosteronism.

Screening

According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes:

Indications for adrenal incidentaloma screening

Patients with possible autonomous cortisol secretion for hypertension and type 2 diabetes mellitus.
Patients with asymptomatic vertebral fractures.
Screening imaging in patients with a hereditary syndrome leading to adrenal tumors.
Family screening with 1 mg dexamethasone test can be considered in cases of bilateral macronodular hyperplasia, especially in younger patients.

Screening measures

Disease	Laboratory tests
Pheochromocytoma	24-hour urine: Fractionated metanephrines Fractionated catecholamines Blood: Fractionated metanephrines
Cushing's syndrome	For patients with symptoms of Cushing's syndrome: 24-hour urinary free cortisol For patients lacking symptoms of Cushing's syndrome: 1 mg overnight dexamethasone suppression test
Primary aldosteronism	Plasma aldosterone concentration, plasma renin activity

References

Template:WH Template:WS

@@ Line 5: / Line 5: @@
 ==Overview==
-According to the [guideline name], screening for [disease name] is not recommended.
+According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes: family screening for patients  with bilateral macronodular [[hyperplasia]], patients with asymptomatic [[vertebral fractures]], patients with possible autonomous [[cortisol]] secretion, patients with a hereditary syndrome leading to [[Adrenal tumor|adrenal tumors]]. Screening test include 24-hour urine [[Metanephrine|fractionated metanephrines]] for [[pheochromocytoma]], 24-hour urinary free [[cortisol]] for patients with symptoms of [[Cushing's syndrome]], and [[Aldosterone|Plasma aldosterone concentration]], [[plasma renin activity]] for patients with [[Primary hyperaldosteronism|Primary aldosteronism]].
 ==Screening==
 *According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes:
 === Indications for adrenal incidentaloma screening ===
-* Patients with possible autonomous cortisol secretion or autonomous cortisol secretion for hypertension and type 2 diabetes mellitus.
+* Patients with possible autonomous [[cortisol]] secretion for [[hypertension]] and [[Diabetes mellitus type 2|type 2 diabetes mellitus.]]
-* Patients with asymptomatic vertebral fractures.
+* Patients with asymptomatic [[vertebral fractures]].
-* Screening imaging in patients with a hereditary syndrome leading to adrenal tumors.
+* Screening imaging in patients with a hereditary syndrome leading to [[Adrenal tumor|adrenal tumors]].
-* Family screening with 1 mg dexamethasone test can be considered in cases of bilateral macronodular hyperplasia, especially in younger patients.
+* Family screening with 1 mg [[Dexamethasone suppression test|dexamethasone test]] can be considered in cases of bilateral macronodular [[hyperplasia]], especially in younger patients.
 === Screening measures ===
@@ Line 20: / Line 20: @@
 !Laboratory tests
 |-
-|Pheochromocytoma
+|[[Pheochromocytoma]]
 |'''24-hour urine:'''
-Fractionated
+* [[Metanephrine|Fractionated metanephrines]]
+* [[Catecholamines|Fractionated catecholamines]]
-metanephrines
-Fractionated
-catecholamines
 '''Blood:'''
+* [[Metanephrine|Fractionated metanephrines]]
-Fractionated
-metanephrines
 |-
-|Cushing's
+|[[Cushing's syndrome]]
-syndrome
+|'''For patients with''' '''symptoms of [[Cushing's syndrome|Cushing's]]''' [[Cushing's syndrome|'''syndrome''']]''':'''
-|'''For patients with'''
+* 24-hour urinary free [[cortisol]]
-'''symptoms of Cushing's'''
+'''For patients lacking''' '''symptoms of [[Cushing's syndrome|Cushing's]]''' [[Cushing's syndrome|'''syndrome''']]''':'''
+* 1 mg overnight [[dexamethasone suppression test]]
-'''syndrome:'''
--hour urinary free
-cortisol
-'''For patients lacking'''
-'''symptoms of Cushing's'''
-'''syndrome:'''
-mg overnight
-dexamethasone
-suppression test
 |-
-|Primary
+|[[Primary hyperaldosteronism|Primary aldosteronism]]
-aldosteronism
+|[[Aldosterone|Plasma aldosterone concentration]], [[plasma renin activity]]
-|Plasma aldosterone
-concentration, plasma
-renin activity
 |}