{"id":512,"date":"2021-05-28T20:14:24","date_gmt":"2021-05-28T20:14:24","guid":{"rendered":"https:\/\/drandre.timemarketing.com.br\/?p=512"},"modified":"2022-01-28T20:46:41","modified_gmt":"2022-01-28T20:46:41","slug":"hiperaldosteronismo-primario","status":"publish","type":"post","link":"https:\/\/drandre.timemarketing.com.br\/index.php\/2021\/05\/28\/hiperaldosteronismo-primario\/","title":{"rendered":"HIPERALDOSTERONISMO PRIM\u00c1RIO"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">EXCESSO DE ALDOSTERONA<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A secre\u00e7\u00e3o excessiva do horm\u00f4nio aldosterona (hiperaldosteronismo prim\u00e1rio) \u00e9 uma causa frequente e subdiagnosticada de hipertens\u00e3o arterial (press\u00e3o alta). Os sinais cl\u00e1ssicos de apresenta\u00e7\u00e3o desta doen\u00e7a s\u00e3o aumento da press\u00e3o arterial associado a n\u00edveis baixos de pot\u00e1ssio. Entretanto, devido \u00e0 detec\u00e7\u00e3o mais precoce, a maior parte dos pacientes diagnosticados atualmente possuem n\u00edveis normais de pot\u00e1ssio no sangue.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"940\" height=\"788\" src=\"https:\/\/drandre.timemarketing.com.br\/wp-content\/uploads\/2021\/05\/aldosterona-.png\" alt=\"\" class=\"wp-image-513\" srcset=\"https:\/\/drandre.timemarketing.com.br\/wp-content\/uploads\/2021\/05\/aldosterona-.png 940w, https:\/\/drandre.timemarketing.com.br\/wp-content\/uploads\/2021\/05\/aldosterona--300x251.png 300w, https:\/\/drandre.timemarketing.com.br\/wp-content\/uploads\/2021\/05\/aldosterona--768x644.png 768w\" sizes=\"auto, (max-width: 940px) 100vw, 940px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">As causas mais comuns do hiperaldosteronismo prim\u00e1rio s\u00e3o adenomas (n\u00f3dulos benignos) nas suprarrenais produtores de aldosterona e a hiperplasia bilateral (quando n\u00e3o h\u00e1 n\u00f3dulos, mas ambas as gl\u00e2ndulas produzem o horm\u00f4nio de forma descontrolada). A secre\u00e7\u00e3o excessiva de aldosterona \u00e9 associada com maior risco de aumento do tamanho e fal\u00eancia do cora\u00e7\u00e3o, infarto do mioc\u00e1rdio e AVC (derrame cerebral).<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>O hiperaldosteronismo prim\u00e1rio deve ser suspeitado sempre que houver alguma das situa\u00e7\u00f5es abaixo:<\/li><li>Hipertens\u00e3o arterial com pot\u00e1ssio baixo no sangue<\/li><li>Hipertens\u00e3o grave ou resistente (geralmente o paciente precisa de tr\u00eas ou mais drogas para baixar a press\u00e3o, incluindo um diur\u00e9tico)<\/li><li>Hipertens\u00e3o e n\u00f3dulo adrenal<\/li><li>Hipertens\u00e3o e hist\u00f3ria familiar de hipertens\u00e3o precoce ou AVC em idade precoce (&lt; 40 anos)<\/li><li>Hipertens\u00e3o e familiares de 1\u00ba grau com hiperaldosteronismo prim\u00e1rio documentado<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline;\">DIAGN\u00d3STICO:<br><\/span><\/strong>A avalia\u00e7\u00e3o inicial em um caso suspeito consiste na dosagem da aldosterona (que se encontra elevada) e da atividade plasm\u00e1tica de renina (que se encontra suprimida). Uma rela\u00e7\u00e3o aldosterona\/atividade plasm\u00e1tica de renina elevada por si s\u00f3 n\u00e3o \u00e9 diagn\u00f3stica de hiperaldosteronismo prim\u00e1rio. Na maior parte dos casos, est\u00e1 indicada a realiza\u00e7\u00e3o de um teste confirmat\u00f3rio, a ser determinado por um endocrinologista especialista no assunto.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">M\u00e9todos de imagem avan\u00e7ados (tomografia computadorizada e\/ou resson\u00e2ncia magn\u00e9tica) s\u00e3o utilizados para avalia\u00e7\u00e3o do formato e aspecto das gl\u00e2ndulas suprarrenais. Tais exames trazem bastantes subs\u00eddios e informa\u00e7\u00f5es, mas \u00e9 imposs\u00edvel apenas por meio deles determinar com exatid\u00e3o de onde se origina a produ\u00e7\u00e3o exagerada do horm\u00f4nio (se de um n\u00f3dulo apenas, se de ambas as gl\u00e2ndulas). Assim, muitas vezes, torna-se necess\u00e1ria a realiza\u00e7\u00e3o de procedimentos diagn\u00f3sticos adicionais para essa finalidade, tais como a coleta de sangue das veias adrenais por meio do cateterismo seletivo realizado por um radiologista intervencionista experiente.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span style=\"text-decoration: underline;\">TRATAMENTO:<\/span><\/strong><br>Em rela\u00e7\u00e3o ao tratamento, a conduta depende do tipo de les\u00e3o identificada (adenoma, hiperplasia uni ou bilateral). O procedimento indicado para os dois primeiros \u00e9 a extra\u00e7\u00e3o cir\u00fargica da gl\u00e2ndula suprarrenal acometida, normalmente por meio da videolaparoscopia. Para casos com hiperplasia bilateral (quando ambas as gl\u00e2ndulas s\u00e3o doentes), n\u00e3o est\u00e1 indicada a realiza\u00e7\u00e3o de cirurgia, mas sim tratamento medicamentoso com drogas que bloqueiam a a\u00e7\u00e3o da aldosterona nos \u00f3rg\u00e3os e tecidos. O uso de medicamentos \u00e9 uma alternativa poss\u00edvel tamb\u00e9m nos casos com risco cir\u00fargico aumentado ou mesmo naqueles que n\u00e3o desejam operar.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>EXCESSO DE ALDOSTERONA A secre\u00e7\u00e3o excessiva do horm\u00f4nio aldosterona (hiperaldosteronismo prim\u00e1rio) \u00e9 uma causa frequente e subdiagnosticada de hipertens\u00e3o arterial (press\u00e3o alta). Os sinais cl\u00e1ssicos de apresenta\u00e7\u00e3o desta doen\u00e7a s\u00e3o aumento da press\u00e3o arterial associado a n\u00edveis baixos de pot\u00e1ssio. Entretanto, devido \u00e0 detec\u00e7\u00e3o mais precoce, a maior parte dos pacientes diagnosticados atualmente possuem n\u00edveis [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":514,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-512","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-adrenais"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>HIPERALDOSTERONISMO PRIM\u00c1RIO - Dr. Andr\u00e9 Faria<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/drandre.timemarketing.com.br\/index.php\/2021\/05\/28\/hiperaldosteronismo-primario\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HIPERALDOSTERONISMO PRIM\u00c1RIO - Dr. Andr\u00e9 Faria\" \/>\n<meta property=\"og:description\" content=\"EXCESSO DE ALDOSTERONA A secre\u00e7\u00e3o excessiva do horm\u00f4nio aldosterona (hiperaldosteronismo prim\u00e1rio) \u00e9 uma causa frequente e subdiagnosticada de hipertens\u00e3o arterial (press\u00e3o alta). Os sinais cl\u00e1ssicos de apresenta\u00e7\u00e3o desta doen\u00e7a s\u00e3o aumento da press\u00e3o arterial associado a n\u00edveis baixos de pot\u00e1ssio. 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