@entity1368 : the internist's XXXX disease.

@entity1 @entity7842 @entity5838 @entity1369 @entity101 @entity1373 @entity916 @entity652 @entity1368 @entity1371 @entity1482
@entity1368 ( @entity1368 ) is a disorder typically characterized by resistant @entity101 , @entity1371 , @entity5838 and suppressed plasma @entity916 activity, and excessive @entity1369 production. A true estimate of the prevalence of the disorder is difficult to estimate because its detection is dependent on the awareness of the healthcare provider to the disorder, but it has generally been felt to be a rare occurrence. Its frequency of detection began to change when Hiramatsu suggested calculating the ratio of plasma @entity1369 /plasma @entity916 activity as a screening tool for the disorder. He found a ratio greater than 75 as a sensitive indicator for @entity1369 -producing @entity652 . Using the ratio, several investigators have found prevalence ranging from 3 to 9%. Two major classifications of @entity1368 exist: @entity1369 -producing @entity652 (APA) and @entity1373 (IHA). Distinguishing between these 2 entities is important clinically, because removal of a unilateral @entity1369 -producing @entity652 may result in correction of elevated blood pressure and @entity1371 . Thus, when evaluating @entity101 @entity1 , @entity1368 should be suspected in those with moderate to severe @entity101 or with @entity101 refractory to standard treatment or in @entity101 @entity1 with disease onset at an early age. The @entity1369 -to- @entity916 ratio is an easy, inexpensive, and rapid means of screening for the disorder. The ratio is the screening test of choice, but further confirmatory testing is required to clinch the diagnosis. Frequently employed confirmatory tests include urinary @entity1369 excretion on a high-salt diet, @entity1369 suppression after a saline infusion, and the @entity7842 suppression test, which is considered the most sensitive confirmatory maneuver. Both high-resolution CT and MRI scans appear to have similar ability to differentiate between APA and IHA. As with essential @entity101 , the goal of treatment is to prevent the long-term sequela of @entity101 . The underlying pathology resulting in @entity1368 dictates the treatment strategy. The drug of choice is @entity1482 . Surgical intervention should be entertained in those @entity1 with @entity1368 in whom imaging studies suggest an @entity652 .
