[Strategy for studying mineralocorticoids other than aldosterone in arterial hypertension of hormonal origin].

Deoxycorticosterone (DOC) and corticosterone (B) are two mineralocorticoid hormones, which are both secretory products of the zona fasciculata and precursors of aldosterone in the zona glomerulosa. Hyperproduction of these compounds plays certainly a role in the pathogenesis of Cushing syndrome hypertension. Their levels in plasma are moderately elevated in half cases of tumour or hyperplasia. In some tumors, the ratio B/DOC is lowered and this might be helpful in diagnosing the malignancy. Moreover, certain tumors secrete exclusively corticosterone and/or DOC. The same mineralocorticoids are responsible for the hypertension in congenital 11-beta-hydroxylase defects (where virilism is present) and congenital 17-alpha-hydroxylase defects (where impuberism is present). Thus, measurements of DOC and corticosterone levels are needed in any case of vascular hypertension associated with hypokalemia and non-elevated renin activity, when routine investigations do not provide immediately the right diagnosis.