What is the role of 18-hydroxycorticosterone measurement in the workup of primary hyperaldosteronism?

Updated: Sep 08, 2020
  • Author: George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London); Chief Editor: Robert P Hoffman, MD  more...
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Levels of 18-hydroxycorticosterone are typically elevated (>100 ng/dL) in patients with APAs and are significantly lower in patients with IHA. Although a diagnostic accuracy of 82% is reported, 18-hydroxycorticosterone levels have been noted to parallel the severity of hyperaldosteronism, and levels of aldosterone and clinical severity are greater in APAs than in IHA.

Hybrid steroid levels (18-OHF and 18-oxoF) are high (3–30 times normal) in with FH-I, normal to mildly elevated in FH-II (3–4 times normal, as in sporadic PA), and mildly to extremely high in FH-III (3–100 times normal).

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