Incidentaloma screening: Difference between revisions
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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]]. | 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== | ==Screening== | ||
*According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes: | *According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes:<ref name="pmid27390021">{{cite journal| author=Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A et al.| title=Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. | journal=Eur J Endocrinol | year= 2016 | volume= 175 | issue= 2 | pages= G1-G34 | pmid=27390021 | doi=10.1530/EJE-16-0467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27390021 }}</ref> | ||
=== Indications for adrenal incidentaloma screening === | === Indications for adrenal incidentaloma screening === | ||
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* [[Metanephrine|Fractionated metanephrines]] | * [[Metanephrine|Fractionated metanephrines]] | ||
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|[[Cushing's syndrome]] | |[[Cushing's syndrome]]<ref name="pmid11275951">{{cite journal| author=Valli N, Catargi B, Ronci N, Vergnot V, Leccia F, Ferriere JM et al.| title=Biochemical screening for subclinical cortisol-secreting adenomas amongst adrenal incidentalomas. | journal=Eur J Endocrinol | year= 2001 | volume= 144 | issue= 4 | pages= 401-8 | pmid=11275951 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11275951 }}</ref> | ||
|'''For patients with''' '''symptoms of [[Cushing's syndrome|Cushing's]]''' [[Cushing's syndrome|'''syndrome''']]''':''' | |'''For patients with''' '''symptoms of [[Cushing's syndrome|Cushing's]]''' [[Cushing's syndrome|'''syndrome''']]''':''' | ||
* 24-hour urinary free [[cortisol]] | * 24-hour urinary free [[cortisol]] | ||
Revision as of 15:42, 6 September 2017
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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:[1]
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:
Blood: |
| Cushing's syndrome[2] | For patients with symptoms of Cushing's syndrome:
For patients lacking symptoms of Cushing's syndrome:
|
| Primary aldosteronism | Plasma aldosterone concentration, plasma renin activity |
References
- ↑ Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A; et al. (2016). "Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors". Eur J Endocrinol. 175 (2): G1–G34. doi:10.1530/EJE-16-0467. PMID 27390021.
- ↑ Valli N, Catargi B, Ronci N, Vergnot V, Leccia F, Ferriere JM; et al. (2001). "Biochemical screening for subclinical cortisol-secreting adenomas amongst adrenal incidentalomas". Eur J Endocrinol. 144 (4): 401–8. PMID 11275951.