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    A short review of primary aldosteronism in a question and answer fashion.
    Endocr Regul 2018 Jan;52(1):27-40
    5Resident Surgeon, 3rd Department of Surgery, Attikon University Hospital, University of Athens School of Medicine , Athens , Greece.
    Objectives: The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. Read More

    The Angiotensin Type 2 Receptor In  Human Adrenocortical Zona Glomerulosa And In Aldosterone-Producing Adenoma: Low Expression And No Functional Role.
    Clin Sci (Lond) 2018 Feb 7. Epub 2018 Feb 7.
    University of Padua, Padova, 35121, Italy
    The angiotensin II type 2 receptor (AT2R) and the angiotensin-(1-7) receptor (MasR) play a cardiovascular protective role by counter-regulating angiotensin II type 1 receptor (AT1R)-mediated effects, but whether this involves blunting of adrenocortical hormone secretion is unknown. We investigated the presence of AT1R, AT2R and MasR in aldosterone-producing adenoma (APA), a condition featuring hyperaldosteronism, and in APA-adjacent tissue. The effect of C21, an AT2R agonist, on CYP11B1 (cortisol synthase) and CYP11B2 (aldosterone synthase) gene expression in NCI-H295R and HAC15 cell lines, and in APA and APA-adjacent tissue was also assessed using the AT1R antagonist irbesartan to ascertain the specificity of C21 effect. Read More

    Common module analysis reveals prospective targets and mechanisms of pediatric adrenocortical adenoma and carcinoma.
    Oncol Lett 2018 Mar 19;15(3):3267-3272. Epub 2017 Dec 19.
    Department of Applied Sciences, Indian Institute of Information Technology, Allahabad, Uttar Pradesh 211012, India.
    Pediatric adrenocortical carcinoma and adrenocortical adenoma are two rare diseases affecting children. Molecular analyses were performed to identify commonalities in gene expression between the diseases. Differentially expressed genes were identified for the pediatric adrenocortical adenoma and carcinoma tissues, as compared with normal tissues, using the expression dataset. Read More

    Overview of aldosterone-related genetic syndromes and recent advances.
    Curr Opin Endocrinol Diabetes Obes 2018 Feb 8. Epub 2018 Feb 8.
    INSERM, UMRS_970, Paris Cardiovascular Research Center.
    Purpose Of Review: Primary aldosteronism is the most common form of secondary hypertension. Early diagnosis and treatment are key to cure of hypertension and prevention of cardiovascular complications. Recent genetic discoveries have improved our understanding on the pathophysiology of aldosterone production and triggered the development of new diagnostic procedures and targeted treatments for primary aldosteronism. Read More

    Testosterone- and Cortisol-secreting Oncocytic Adrenocortical Adenoma in the Pediatric Age-group.
    Pediatr Dev Pathol 2018 Jan 1:1093526617753045. Epub 2018 Jan 1.
    3 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
    Oncocytic tumors are epithelial neoplasms that occur in various organs, including adrenal glands. Oncocytic adrenocortical adenomas and carcinomas are uncommon but well-known pathological entities in adults. However, generally oncocytic tumors, particularly in the adrenal glands, are very rare in the pediatric age-group. Read More

    Adrenal Axis Insufficiency Following Endoscopic Transsphenoidal Resection of Pituitary Adenomas.
    World Neurosurg 2018 Feb 5. Epub 2018 Feb 5.
    Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, United States.
    Introduction: Hormonal insufficiency of one or more pituitary axes can appear after pituitary surgery. Adrenal axis impairment after surgery can lead to serious consequences if not identified and treated.

    Objective: Assess early and late post-operative adrenal insufficiency (AI) and identify the risk factors predicting their occurrence after endoscopic transsphenoidal resection of pituitary adenomas. Read More

    [Clinical report of testicular hypoplasia combined with 21-hydroxylase deficiency].
    Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2018 Feb;35(1):29-33
    Reproductive Center, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi 541002, China; Reproductive Medicine Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China. Email:
    OBJECTIVE To investigate the correlation of 21-hydroxylase deficiency (21-OHD) with male testicular dysplasia. METHODS Clinical data of 8 infertile males with congenital adrenal hyperplasia due to 21-OHD was retrospectively analyzed. In addition, potential mutations of the CYP21A2 gene was detected. Read More

    Long-term follow-up and novel splice donor mutation inin a Chinese family.
    Oncotarget 2018 Jan 7;9(2):1577-1586. Epub 2017 Dec 7.
    Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha, China.
    Heterozygous germline mutation of thetumor suppressor gene is responsible for multiple endocrine neoplasia type 1. Parathyroid and thoracic neuroendocrine tumor specimens and DNA from two Han Chinese MEN1 family patients were analyzed using whole exome and Sanger sequencing. The proband (II-3) was sequentially diagnosed with pituitary adenoma, pancreatic tumor, adrenal cortical tumor, abdominal lipoma, and parathyroid adenoma during the 6-year follow-up. Read More

    A First Report of Synchronous Intracapsular and Extracapsular Hepatic Adenoma.
    Case Rep Surg 2017 19;2017:9053568. Epub 2017 Dec 19.
    Medical Faculty, Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey.
    Although the gallbladder is the most common site of ectopic liver, it has been reported in many other organs, such as kidney, adrenal glands, pancreas, omentum, stomach, esophagus, mediastinum, lungs, and heart. Hepatocytes in an ectopic liver behave like normal hepatocytes; furthermore, they can be associated with the same pathological findings as those in the main liver. Ectopic liver in the gallbladder can undergo fatty change, hemosiderosis, cholestasis, cirrhosis, hemangioma, focal nodular hyperplasia, adenoma, and even carcinogenesis. Read More

    Macrolides for KCNJ5-mutated aldosterone-producing adenoma (MAPA): design of a study for personalized diagnosis of primary aldosteronism.
    Blood Press 2018 Feb 6:1-6. Epub 2018 Feb 6.
    a Department of Medicine-DIMED, Clinica dell'Ipertensione Arteriosa , University of Padova , Padova , Italy.
    Purpose: Aldosterone-producing adenoma (APA) is the main curable cause of endocrine hypertension cause of primary aldosteronism (PA) and it is in up to 66% of all cases investigated with adrenal vein sampling (AVS). Mutations in the KCNJ5 potassium channel involve up to 70% of APA and cause the most florid PA phenotypes. The recent finding that macrolide antibiotics specifically inhibit in vitro the altered function of mutated KCNJ5 channels has opened new horizons for the diagnosis and treatment of APA with KCNJ5 mutations in that it can allow identification and target treatment of PA patients harbouring a mutated APA. Read More

    Operative technique: Transperitoneal robotic adrenalectomy.
    J Visc Surg 2018 Jan 27. Epub 2018 Jan 27.
    Service de chirurgie digestive, hépatobiliaire, endocrinienne, et cancérologique, Hospital Brabois-Adultes, université de Lorraine, CHU de Nancy, 11, allée du Morvan, 54511 Vandœuvre-les-Nancy, France; Unité Inserm U954 « Nutrition - génétique et exposition aux risques environnementaux », faculté de médecine, université de Lorraine, 54511 Vandœuvre-les-Nancy, France. Electronic address:

    Robot-assisted laparoendoscopic single site adrenalectomy: A comparison of 3 different port platforms with 3 case reports.
    Medicine (Baltimore) 2017 Dec;96(51):e9479
    Department of Surgery, Division of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan.
    Rationale: Laparoscopic adrenalectomy is currently the standard of care for adrenal lesion. Minimal invasive laparoscopic surgery such as laparoendoscopic single site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) have been developed to improve cosmetic outcomes and reduce postoperative pain. However, there are still some problems related to instruments and port limitation during LESS surgery. Read More

    Case report of a bilateral adrenal myelolipoma associated with Cushing disease.
    Medicine (Baltimore) 2017 Dec;96(52):e9455
    Division of Endocrinology and Metabolism, Departments of Internal Medicine.
    Rationale: Adrenal myelolipomas are rare benign tumors, composed of a variable mixture of mature adipose tissue and hematopoietic tissue. These tumors are frequently detected incidentally and are usually asymptomatic, and hormonally inactive.

    Patient Concerns: During a routine health checkup, a 52-year-old man was found to have a tumor on the bilateral adrenal glands. Read More

    Multiple Salivary Cortisol Measurements Are a Useful Tool to Optimize Metyrapone Treatment in Patients with Cushing's Syndromes Treatment: Case Presentations.
    Front Endocrinol (Lausanne) 2017 11;8:375. Epub 2018 Jan 11.
    Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan.
    Measuring salivary cortisol is both convenient and non-invasive for patients; however, its usefulness as a marker for monitoring medical therapy has not yet been established. The aim of this study was to assess the utility of multiple salivary cortisol measurements in patients with Cushing's syndrome (CS) during medical therapy. Six patients with CS (three with cortisol-secreting adrenocortical adenoma and three with ACTH-secreting pituitary adenoma) were recruited. Read More

    Who was Dr. William C. Baum?
    World J Surg 2018 Jan 19. Epub 2018 Jan 19.
    Department of Surgery, University of Virginia School of Medicine, P O Box 800709, Charlottesville, VA, 22908, USA.
    The first discovery of primary hyperaldosteronism secondary to an aldosterone-secreting adrenal adenoma has been credited solely to Dr. Jerome Conn, an endocrinologist at the University of Michigan and for whom, Conn syndrome was named. Dr. Read More

    Concurrent endocrine neoplasias in dogs and cats: a retrospective study (2004-2014).
    Vet Rec 2018 Jan 19. Epub 2018 Jan 19.
    Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
    Multiple endocrine neoplasia (MEN) is a well-known syndrome in human medicine, whereas only a few cases of concurrent endocrine neoplasias have been reported in dogs and cats. The aim of this study was to evaluate the prevalence of concurrent endocrine neoplasias in dogs and cats at our clinic, identify possible breed and sex predispositions and investigate similarities with MEN syndromes in humans. Postmortem reports of 951 dogs and 1155 cats that died or were euthanased at the Clinic for Small Animal Internal Medicine, University of Zurich, between 2004 and 2014 were reviewed, and animals with at least two concurrent endocrine neoplasias and/or hyperplasias were included. Read More

    Effects of Mifepristone on Nonalcoholic Fatty Liver Disease in a Patient with a Cortisol-Secreting Adrenal Adenoma.
    Case Rep Endocrinol 2017 19;2017:6161348. Epub 2017 Nov 19.
    Corcept Therapeutics, 149 Commonwealth Drive, Menlo Park, CA 94025, USA.
    Cushing syndrome (CS), a complex, multisystemic condition resulting from prolonged exposure to cortisol, is frequently associated with nonalcoholic fatty liver disease (NAFLD). In patients with adrenal adenoma(s) and NAFLD, it is essential to rule out coexisting endocrine disorders like CS, so that the underlying condition can be properly addressed. We report a case of a 49-year-old woman with a history of hypertension, prediabetes, dyslipidemia, biopsy-confirmed steatohepatitis, and benign adrenal adenoma, who was referred for endocrine work-up for persistent weight gain. Read More

    GENETICS IN ENDOCRINOLOGY: The expanding genetic horizon of primary aldosteronism.
    Eur J Endocrinol 2018 Jan 18. Epub 2018 Jan 18.
    P Mulatero, Department of Medical Sciences, University of Torino, Torino, Italy
    Aldosterone is the main mineralocorticoid hormone in humans and plays a key role in maintaining water and electrolyte homeostasis. Primary aldosteronism (PA), characterized by autonomous aldosterone overproduction by the adrenal glands, affects 6% of the general hypertensive population and can be either sporadic or familial. Aldosterone producing adenoma (APA) and bilateral adrenal hyperplasia (BAH) are the two most frequent subtypes of sporadic PA, and 4 forms of familial hyperaldosteronism (FH-I to FH-IV) have been identified. Read More

    The computed tomography adrenal wash-out analysis properly classifies cortisol secreting adrenocortical adenomas.
    Endocrine 2018 Jan 13. Epub 2018 Jan 13.
    Department of Endocrinology, University Hospital of Nancy, Nancy, France.
    Purpose: Adrenocortical lesions are characterized through imaging, hormonal and histopathological analysis. Our aim was to compare the radiological features of adrenocortical lesions with their cortisol-secreting status and histopathological Weiss score.

    Methods: Seventy five patients operated between 2004 and 2016 in the University Hospital of Nancy for either adrenocortical carcinomas (ACC) or adrenocortical adenomas (ACA) were enrolled in this study. Read More

    Adrenocortical oncocytoma: 11 Case reports and review of the literature.
    Medicine (Baltimore) 2017 Dec;96(48):e8750
    Department of Urology.
    Rationale: Adrenocortical oncocytoma is an extremely rare tumor of the adrenal gland. Its diagnostic criteria and biological behavior has not yet reached a consensus. The purpose of this study is to investigate the clinical characteristics of adrenocortical oncocytoma. Read More

    Analysis of circulating extracellular vesicle-associated microRNAs in cortisol-producing adrenocortical tumors.
    Endocrine 2018 Feb 3;59(2):280-287. Epub 2018 Jan 3.
    2nd Department of Medicine, Semmelweis University, 1088, Budapest, Szentkiralyi str. 46., Hungary.
    Purpose: Circulating microRNAs (miRNA) have been described in patients with adrenocortical tumors, but the expression of miRNAs in non-functioning and cortisol-producing tumors has not been yet compared. Therefore, the objective of this study was to evaluate the expression of plasma extracellular vesicle (EV)-associated microRNAs in patients with non-functioning adrenocortical adenoma (NFA), cortisol-producing adrenocortical adenoma (CPA) and cortisol-producing adrenocortical carcinoma (CP-ACC).

    Methods: Preoperative plasma EV samples of 13 NFAs, 13 CPAs and 9 CP-ACCs were subjected to extracellular vesicle isolation. Read More

    Addison disease and normocalcemic primary hyperparathyroidism in a dog with multiple endocrine neoplasia.
    Open Vet J 2017 5;7(4):332-336. Epub 2017 Dec 5.
    Cátedra de Patología, Fac. de Ciencias Veterinarias, UBA, Av. Chorroarín 280, Ciudad Autónoma de Buenos Aires, Argentina.
    A 12-year old dog with a 9-year history of primary adrenal insufficiency was referred to the service for hyporexia, muscle weakness, polyuria and polydipsia. Ultrasound examination showed an unresectable mass in the left adrenal gland, with local vascular invasion, which prompted the euthanasia of the animal. Additionally, necropsy revealed a nodular lesion in the right adrenal gland and enlargement of one of the four parathyroid glands. Read More

    Purkinje cell protein 4 expression is associated with DNA methylation status in aldosterone-producing adenoma.
    J Clin Endocrinol Metab 2017 Dec 26. Epub 2017 Dec 26.
    Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
    Context: Aldosterone production is stimulated by activation of calcium signaling in aldosterone-producing adenoma (APA), and epigenetic factors such as DNA methylation may be associated with the expression of genes involved in aldosterone regulation.

    Objective: Our aim was to investigate the DNA methylation of genes related to calcium signaling cascades in APA, and the association of mutations in genes linked to APA with DNA methylation levels.

    Methods: Non-functioning adrenocortical adenoma (NF, n=12) and APA (n=35) samples were analyzed. Read More

    Robotic-assisted laparoscopic surgery for pediatric tumors: a bicenter experience.
    J Robot Surg 2017 Dec 29. Epub 2017 Dec 29.
    Service de chirurgie viscérale pédiatrique, Hôpital de Clocheville-CHU de TOURS, 49 boulevard Béranger, 37044, Tours Cedex, France.
    Mini-invasive surgery is more and more integrated in pediatric surgery. The robotic-assisted surgery brought new advantages from which the patient and the surgeon could benefit compared to laparoscopy. Its use in oncological surgery is still controversial. Read More

    Complete remission of hypertension in a hemodialysis patient after adrenalectomy for primary aldosteronism and renal transplantation.
    CEN Case Rep 2017 Dec 29. Epub 2017 Dec 29.
    Department of Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
    A 64-year-old man was admitted to our hospital for the hormonal evaluation of a right adrenal adenoma. He had been diagnosed with severe proteinuria and hypertension, and antihypertensive treatment was started at the age of 60. His renal function gradually declined, and hemodialysis was begun at the age of 64. Read More

    Comparison of hydrocortisone and prednisone in the glucocorticoid replacement therapy post-adrenalectomy of Cushing's Syndrome.
    Oncotarget 2017 Dec 31;8(62):106113-106120. Epub 2017 Aug 31.
    University of the District of Columbia, Washington, DC, USA.
    Cushing's syndrome requires glucocorticoid replacement following adrenalectomy. Based on a simplified glucocorticoid therapy scheme and the peri-operative observation, we investigated its efficacy and safety up to 6 months post-adrenalectomy in this cohort study. We found the adrenocorticotropic hormone (ACTH) levels were normal post-adrenalectomy, and sufficient to stimulate the recovery of the dystrophic adrenal cortex, thus exogenous supplemental ACTH might not be necessary. Read More

    Oncocytic Adreno Cortical Tumors: Pathological Features of 16 Cases and Review of the Literature.
    J Environ Pathol Toxicol Oncol 2017 ;36(3):237-244
    Department of General Surgery, Ege University, Izmir, Turkey.
    Oncocytic neoplasms of the adrenal gland are extremely rare tumors. These tumors differ from their nononcocytic counterparts in some respects. The aim of this study was to review and discuss the clinical, histological, and immunohistochemical features of as well as the prognosis for these rare tumors. Read More

    Targeting CXCR4 (CXC Chemokine Receptor Type 4) for Molecular Imaging of Aldosterone-Producing Adenoma.
    Hypertension 2018 Feb 26;71(2):317-325. Epub 2017 Dec 26.
    From the Department of Internal Medicine I, Endocrinology and Diabetes Unit (B.H., C.T.F., M.F., K.L., S.H.), Department of Nuclear Medicine (A.S., K.H., A.K.B., C.B.), and Comprehensive Cancer Center Wuerzburg (T.D., M.F.), University Hospital of Wuerzburg, University of Wuerzburg, Germany; Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Italy (P.M., T.A.W., S.M.); Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Germany (F.B., M.R., T.A.W., Y.R.); Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universität München, Germany (M.M.); Endocrinology in Charlottenburg, Berlin, Germany (M.Q.); Department of General, Visceral, and Transplant Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Germany (N.R.); Department of Pathology, University of Würzburg, Germany (V.W.); Division of Endocrinology, G.V. (Sonny) Montgomery VA Medical Center, MS (C.E.G.-S.); Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Germany (A.-C.R.); ENDOC, Center for Endocrine Tumors, Hamburg, Germany (S.P.); Pharmaceutical Radiochemistry, Technische Universität München, Garching bei München, Germany (H.-J.W.); and Scintomics GmbH, Fürstenfeldbruck, Germany (S.K.).
    Primary aldosteronism is the most frequent cause of secondary hypertension and is associated with increased morbidity and mortality compared with hypertensive controls. The central diagnostic challenge is the differentiation between bilateral and unilateral disease, which determines treatment options. Bilateral adrenal venous sampling, currently recommended for differential diagnosis, is an invasive procedure with several drawbacks, making it desirable to develop novel noninvasive diagnostic tools. Read More

    [Diagnostic value of urinary free cortisol in the subclinical Cushing's syndrome in patients with adrenal incidentaloma].
    Zhonghua Yi Xue Za Zhi 2017 Dec;97(46):3632-3635
    Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
    To evaluate the efficacy of 24 h urinary free cortisol (24 h UFC) in the diagnosis of subclinical Cushing's syndrome (SCS), and explore the best diagnostic cut-off value.The clinical data of patients with adrenal incidentaloma in Chinese PLA General Hospital between January 2008 and December 2016 was retrospectively reviewed and analyzed. All SCS patients were diagnosed based on the current Cushing's syndrome (CS) guidelines and confirmed by histopathology and then treated as study group, and additional patients with non-functional adrenal adenoma (NFA) were enrolled as control group. Read More

    A Novel Case of SomaticMutation in Pediatric-Onset Aldosterone-Producing Adenoma.
    J Endocr Soc 2017 Aug 11;1(8):1056-1061. Epub 2017 Jul 11.
    Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan.
    Aldosterone-producing adenoma (APA), a subtype of primary aldosteronism, is a common cause of secondary hypertension in adults. Somaticmutations have been identified in about 12%-80% of adult-onset APA. In contrast, there has been no previous reported case of pediatric-onset APA in whom a somaticmutation was confirmed. Read More

    Aldosterone-Producing Cell Clusters Frequently Harbor Somatic Mutations and Accumulate With Age in Normal Adrenals.
    J Endocr Soc 2017 Jul 12;1(7):787-799. Epub 2017 May 12.
    Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109.
    Context: Aldosterone synthase (CYP11B2) immunohistochemistry and next-generation sequencing (NGS) have revealed the frequent presence of aldosterone-producing cell clusters (APCCs) harboring somatic mutations in aldosterone-regulating genes in adrenals from Americans without defined hypertension status.

    Objective: Determine the frequency and somatic mutation status of APCCs in a Japanese nonhypertensive cohort.

    Design Setting Patients And Interventions: Adrenals from 837 consecutive autopsies at a Japanese institution, Tohoku University Hospital, were screened to select 107 unilateral adrenal glands from nonhypertensive patients. Read More

    A Case of Adrenal Vein Sampling in Primary Aldosteronism With Homolateral Suppression.
    J Endocr Soc 2017 May 17;1(5):401-406. Epub 2017 Mar 17.
    Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Torino, 10126 Italy.
    Context: Adrenal venous sampling (AVS) is regarded as the gold standard for diagnosis of primary aldosteronism (PA) subtypes, although some authors have questioned its diagnostic accuracy and highlighted the lack of standardized procedure protocols and interpretation criteria for AVS. In particular, the usefulness of cosyntropin stimulation and benefit of superselective adrenal vein catheterization have been hotly debated.

    Objective: We report a case that highlights the potential pitfalls of superselective sampling and demonstrates a negligible effect of cosyntropin stimulation on aldosterone secretion in nonadenomatous adrenal tissue when an aldosterone-producing adenoma (APA) is present. Read More

    New Advances in the Diagnostic Workup of Primary Aldosteronism.
    J Endocr Soc 2017 Mar 27;1(3):149-161. Epub 2017 Jan 27.
    Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Greenslopes Hospital, Greenslopes and Princess Alexandra Hospitals, Brisbane, Queensland, Australia 4102.
    Primary aldosteronism is an important and common cause of hypertension that carries a high burden of morbidity. Outcomes, however, are excellent if diagnosed and treated appropriately. The diagnostic workup for primary aldosteronism is complex and comprises three steps: (1) screening, (2) confirmatory testing, and (3) subtype differentiation. Read More

    Harvey Cushing Treated the First Known Patient With Carney Complex.
    J Endocr Soc 2017 Oct 28;1(10):1312-1321. Epub 2017 Sep 28.
    Section of Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892.
    Context: Carney complex (CNC) is a syndrome characterized by hyperplasia of endocrine organs and may present with clinical features of Cushing syndrome and acromegaly due to functional adrenal and pituitary gland tumors. CNC has been linked to mutations in the regulatory subunit of protein kinase A type I-alpha () gene.

    Design: Tissue samples were taken from the hypothalamus or thalamus or tumors of patients with pituitary adenomas seen and operated on by neurosurgeon Harvey Cushing between 1913 and 1932. Read More

    Challenges in surgical pathology of adrenocortical tumours.
    Histopathology 2018 Jan;72(1):82-96
    Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
    Adrenocortical carcinomas are rare tumours that can be diagnostically challenging. Numerous multiparametric scoring systems and diagnostic algorithms have been proposed to differentiate adrenocortical adenoma from adrenocortical carcinoma. Adrenocortical neoplasms must also be differentiated from other primary adrenal tumours, such as phaeochromocytoma and unusual primary adrenal tumours, as well as metastases to the adrenal gland. Read More

    Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling.
    J Clin Med Res 2018 Jan 1;10(1):66-71. Epub 2017 Dec 1.
    Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Japan.
    Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Read More

    Adrenal Vein Sampling Is the Preferred Method to Select Patients With Primary Aldosteronism for Adrenalectomy: Con Side of the Argument.
    Hypertension 2018 01;71(1):10-14
    From the Department of Internal Medicine (J.D., J.W.M.L.) and Department of Health Evidence (G.J.v.d.W.), Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Hypertension, Institute of Cardiology, Warsaw, Poland (A.P.); and Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany (J.W.M.L).

    Adrenal Vein Sampling Is the Preferred Method to Select Patients With Primary Aldosteronism for Adrenalectomy: Pro Side of the Argument.
    Hypertension 2018 01;71(1):5-9
    From the Clinica dell'Ipertensione Arteriosa (G.P.R.) and Department of Medicine, DIMED (G.P.R.), University of Padova, Italy; Hudson Institute of Medical Research, Clayton Victoria, Australia (J.W.F.); and Monash University, Clayton, Victoria, Australia (J.W.F.).

    Negative surgical exploration in patients with Cushing's disease: benefit of two-thirds gland resection on remission rate and a review of the literature.
    J Neurosurg 2017 Dec 8:1-8. Epub 2017 Dec 8.
    Department of Neurosurgery.
    OBJECTIVE The authors report their single-institution experience with the pathological findings, rates of remission, and complications in patients with presumed Cushing's disease (CD) who underwent a two-thirds pituitary gland resection when no adenoma was identified at the time of transsphenoidal surgery (TSS). The authors also review the literature on patients with CD, negative surgical exploration, and histological findings. METHODS This study is a retrospective analysis of cases found in neurosurgery and pathology department databases between 1989 and 2011. Read More

    The role of dynamic post-contrast T1-w MRI sequence to characterize lipid-rich and lipid-poor adrenal adenomas in comparison to non-adenoma lesions: preliminary results.
    Abdom Radiol (NY) 2017 Dec 6. Epub 2017 Dec 6.
    Department of Advanced Biomedical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
    Purpose: The purpose of the article is to compare the features of wash-out (WO) parameters between lipid-rich and lipid-poor adrenal adenomas as well as with a group of non-adenoma adrenal lesions.

    Methods: 46 patients (36 F and 10 M, median age 58 years) with unilateral adrenal lesions (35 adenomas, 7 pheochromocytomas, 1 carcinoma, and 3 metastases) were prospectively evaluated; adrenal lesions were divided into adenomas (Group 1) and non-adenomas (Group 2). MR imaging was performed with a 3-Tesla scanner using pre- and post-contrast dedicated sequences. Read More

    Coexistence of Primary Hyperaldosteronism and Graves' Disease, a Rare Combination of Endocrine Disorders: Is It beyond a Coincidence-A Case Report and Review of the Literature.
    Case Rep Endocrinol 2017 30;2017:4050458. Epub 2017 Oct 30.
    Department of Endocrinology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.
    Background: Primary hyperaldosteronism is a known cause for secondary hypertension. In addition to its effect on blood pressure, aldosterone exhibits proinflammatory actions and plays a role in immunomodulation/development of autoimmunity. Recent researches also suggest significant thyroid dysfunction among patients with hyperaldosteronism, but exact causal relationship is not established. Read More

    Aldosterone-Producing Cell Clusters in Normal and Pathological States.
    Horm Metab Res 2017 Dec 4;49(12):951-956. Epub 2017 Dec 4.
    Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.
    Primary aldosteronism (PA) significantly increases the risk of cardiovascular complications, and early diagnosis and targeted treatment based on its pathophysiology is warranted. Next-generation sequencing (NGS) has revealed recurrent somatic mutations in aldosterone-driving genes in aldosterone-producing adenoma (APA). By applying CYP11B2 (aldosterone synthase) immunohistochemistry and NGS to adrenal glands from normal subjects and PA patients, we and others have shown that CYP11B2-positive cells make small clusters, termed aldosterone-producing cell clusters (APCC), beneath the adrenal capsule, and that APCC harbor somatic mutations in genes mutated in APA. Read More

    Health-Related Quality of Life and Mental Health in Primary Aldosteronism: A Systematic Review.
    Horm Metab Res 2017 Dec 4;49(12):943-950. Epub 2017 Dec 4.
    Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
    The aim of this review was to determine the impact of primary aldosteronism on health-related quality of life (HRQoL) and mental health. We performed a systematic literature search up to July 2017 in six electronic databases. First, we screened the articles derived from this search based on title and abstract. Read More

    Subtyping of Patients with Primary Aldosteronism: An Update.
    Horm Metab Res 2017 Dec 4;49(12):922-928. Epub 2017 Dec 4.
    Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.
    Primary aldosteronism (PA) comprises two main subtypes: unilateral aldosteronism, mainly caused by aldosterone-producing adenoma; and bilateral adrenal hyperplasia. Establishing the correct subtype in patients with PA is indispensible for choice of treatment. In addition to established methods, alternative tests are evolving for subtyping. Read More

    Subtyping of primary aldosteronism with adrenal vein sampling: Hormone- and side-specific effects of cosyntropin and metoclopramide.
    Surgery 2017 Nov 30. Epub 2017 Nov 30.
    Hypertension Unit, Department of Medicine, DIMED, Padova, Italy.
    Background: Cosyntropin and metoclopramide can affect the subtyping of primary aldosteronism when used with adrenal vein sampling by exerting hormone- and side-specific effects on cortisol and aldosterone secretion. We investigated how these stimuli affect the selectivity index, the relative aldosterone secretion index, and the lateralization index in consecutive primary aldosteronism patients submitted to adrenal vein sampling.

    Methods: We recruited 171 patients; of these, 149 underwent adrenal vein sampling before and after stimulation with cosyntropin (250 µg intravenous bolus, n= 53, 73% with an aldosterone-producing adenoma) or with metoclopramide (10 mg intravenous bolus, n= 96, 65% aldosterone-producing adenoma), and 32 with an aldosterone-producing adenoma were investigated for the relative gene expression of dopamine, melanocortin 2, and 5-hydroxytryptamine (serotonin) 4 receptor with microarrays. Read More

    Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery.
    Oncotarget 2017 Nov 7;8(54):93251-93257. Epub 2017 Oct 7.
    Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China.
    Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed. Read More

    A Case of Cushing's Syndrome in Pregnancy.
    Iran J Med Sci 2017 Nov;42(6):607-610
    Department of Obstetrics and Gynecology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
    Cushing's syndrome (CS) occurs rarely during pregnancy. CS can be caused by prolonged abnormal exposure to excess glucocorticoids leading to special and significant signs and symptoms. It is often difficult to diagnose pathological hypercortisolism in pregnant women since some symptoms of the disease might be due to a complicated pregnancy, including preeclampsia or gestational diabetes. Read More

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