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    Caveolin 1-related autophagy initiated by aldosterone-induced oxidation promotes liver sinusoidal endothelial cells defenestration.
    Redox Biol 2017 Jul 13;13:508-521. Epub 2017 Jul 13.
    Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address:
    Aldosterone, with pro-oxidation and pro-autophagy capabilities, plays a key role in liver fibrosis. However, the mechanisms underlying aldosterone-promoted liver sinusoidal endothelial cells (LSECs) defenestration remain unknown. Caveolin 1 (Cav1) displays close links with autophagy and fenestration. Read More
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    A Comparison of Robotic Versus Laparoscopic Adrenalectomy in Patients With Primary Hyperaldosteronism.
    Surg Laparosc Endosc Percutan Tech 2017 Jul 19. Epub 2017 Jul 19.
    Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH.
    Background: Over the last decade, robotic approaches have been described for removing adrenal tumors. Although there are reports comparing robotic and laparoscopic techniques in general, there are limited data on outcomes in patients with primary hyperaldosteronism (PHA). The aim of this study is to compare the safety and efficacy of robotic adrenalectomy (RA) versus laparoscopic adrenalectomy (LA) for PHA. Read More
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    Effects of Eplerenone on Resistance to Antihypertensive Medication in Patients with Primary or Secondary Hyperaldosteronism.
    J Transl Int Med 2017 Jun 30;5(2):93-99. Epub 2017 Jun 30.
    Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Canada.
    Background And Objectives: Resistant hypertension is an important problem; nearly half of diagnosed hypertensives are not controlled to target blood pressure levels, and approximately 90% of strokes occur among patients with resistant hypertension. Primary aldosteronism accounts for approximately 20% of resistant hypertension, but the role of secondary hyperaldosteronism in resistant hypertension is seldom considered. We assessed the effects of eplerenone in patients with hypertension and either primary or secondary hyperaldosteronism. Read More
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    Diagnosis and management of primary aldosteronism.
    Arch Endocrinol Metab 2017 May-Jun;61(3):305-312
    Unidade de Suprarrenal, Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular - LIM42, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brasil.
    Primary aldosteronism (PA) is the most common form of secondary hypertension (HTN), with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential HTN and the same degree of blood pressure elevation. PA is characterized by an autonomous aldosterone production causing sodium retention, plasma renin supression, HTN, cardiovascular damage, and increased potassium excretion, leading to variable degrees of hypokalemia. Read More
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    Nationwide review of hormonally active adrenal tumors highlights high morbidity in pheochromocytoma.
    J Surg Res 2017 Jul 20;215:204-210. Epub 2017 Apr 20.
    Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
    Background: Adrenal adenomas are benign tumors often discovered incidentally, and >70% are hormonally inactive. The remaining subset may produce excess aldosterone, cortisol, or catecholamine. Perioperative outcomes after adrenalectomy for such "hormonally active" tumors remain unclear. Read More
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    Comparison of C-arm computed tomography and on-site quick cortisol assay for adrenal venous sampling: A retrospective study of 178 patients.
    Eur Radiol 2017 Jul 4. Epub 2017 Jul 4.
    Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei, 100, Taiwan.
    Objectives: To compare the performance of on-site quick cortisol assay (QCA) and C-arm computed tomography (CT) assistance on adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation.

    Methods: The institutional review board at our hospital approved this retrospective study, which included 178 consecutive patients with primary aldosteronism. During AVS, we used C-arm CT to confirm right adrenal cannulation between May 2012 and June 2015 (n = 100) and QCA for bilateral adrenal cannulation between July 2015 and September 2016 (n = 78). Read More
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    Diagnostic value of potassium level in a spot urine sample as an index of 24-hour urinary potassium excretion in unselected patients hospitalized in a hypertension unit.
    PLoS One 2017 29;12(6):e0180117. Epub 2017 Jun 29.
    Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland.
    Background: Primary hyperaldosteronism may be associated with elevated 24-hour urinary potassium excretion. We evaluated the diagnostic value of spot urine (SU) potassium as an index of 24-hour urinary potassium excretion.

    Methods: We measured SU and 24-hour urinary collection potassium and creatinine in 382 patients. Read More
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    Rapid Screening of Primary Aldosteronism by a Novel Chemiluminescent Immunoassay.
    Hypertension 2017 Aug 26;70(2):334-341. Epub 2017 Jun 26.
    From the Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine (R.M., Y.O., Y.T., M.K., S.I., F.S.) and Department of Pathology (H.S.), Tohoku University Hospital, Sendai, Miyagi, Japan; Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan (Y.T., F.S.); Diagnostics Research Laboratories, Diagnostics Development Operations, Diagnostics Division, Wako Pure Chemical Industries, Ltd, Osaka, Japan (S.Y., T.A.); and Division of Endocrinology, G.V. (Sonny) Montgomery VA Medical Center and University of Mississippi Medical Center, Jackson (C.E.G.-S.).
    Measurement of plasma aldosterone and renin concentration, or activity, is useful for selecting antihypertensive agents and detecting hyperaldosteronism in hypertensive patients. However, it takes several days to get results when measured by radioimmunoassay and development of more rapid assays has been long expected. We have developed chemiluminescent enzyme immunoassays enabling the simultaneous measurement of both aldosterone and renin concentrations in 10 minutes by a fully automated assay using antibody-immobilized magnetic particles with quick aggregation and dispersion. Read More
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    High resolution magnetic resonance imaging for exposing facial nerve zonal vulnerability to microbleeds: A rare cause of facial palsy.
    Neuroradiol J 2017 Aug 20;30(4):385-388. Epub 2017 Jun 20.
    1 Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
    Background We report a case of hypertensive microbleeds strategically located at the attached segment (AS) and root entry zone (REZ) at the left facial nerve causing facial paralysis. Case Report A 60-year-old woman presented with sudden onset left facial paralysis. Medical history was significant for poorly controlled hypertension secondary to bilateral adrenal hyperplasia (primary hyperaldosteronism). Read More
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    [The application of captopril challenge test in the diagnosis of primary aldosteronism].
    Zhonghua Nei Ke Za Zhi 2017 Jun;56(6):402-408
    Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
    Objective: To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA). Methods: A total of 674 patients [(45.0±13. Read More
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    Aldosterone-Producing Adenomas: Histopathology-Genotype Correlation and Identification of a Novel CACNA1D Mutation.
    Hypertension 2017 Jul 5;70(1):129-136. Epub 2017 Jun 5.
    From the Department of Pathology (G.C.T., N.M.S.T.L., I.M.R.), Department of Medicine (L.K.C., N.A.K., N.S., E.A.A.), and UKM Medical Molecular Biology Institute (UMBI) (N.M.M., A.R.A.J.), The National University of Malaysia Medical Centre; Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences, University of Innsbruck, Austria (G.N., A.P., J.S.); 1st Department of Internal Medicine-Cardioangiology (J.C., M.S.) and Department of Pathology (A.R.), Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic; and Barts Heart Centre, William Harvey Research Institute, Queen Mary University London, United Kingdom (M.J.B.).
    Mutations in KCNJ5, ATP1A1, ATP2B3, CACNA1D, and CTNNB1 are thought to cause the excessive autonomous aldosterone secretion of aldosterone-producing adenomas (APAs). The histopathology of KCNJ5 mutant APAs, the most common and largest, has been thoroughly investigated and shown to have a zona fasciculata-like composition. This study aims to characterize the histopathologic spectrum of the other genotypes and document the proliferation rate of the different sized APAs. Read More
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    Laparoscopic Adrenalectomy for Conn's Syndrome is Beneficial to Patients and is Cost Effective in England.
    J Invest Surg 2017 May 12:1-7. Epub 2017 May 12.
    a Department of Endocrine Surgery, Churchill Hospital , Oxford University Hospitals NHS Trust , Oxford , United Kingdom.
    Purpose: Adrenalectomy has the potential to cure or improve the control of hypertension in patients with primary hyperaldosteronism due to unilateral adrenal adenoma (Conn's syndrome). This study assesses the patients' perception of, and costs associated with, laparoscopic adrenalectomy for Conn's syndrome.

    Materials And Methods: Clinical, radiological, operative, and pathological data were collected on patients undergoing adrenalectomy for Conn's syndrome over 8-years period in a UK tertiary referral center. Read More
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    A case of confirmed primary hyperaldosteronism diagnosed despite normal screening investigations.
    N Z Med J 2017 May 12;130(1455):129-132. Epub 2017 May 12.
    Department of Surgery, Wellington Regional Hospital, Newtown, Wellington.
    Primary hyperaldosteronism is a common cause of hypertension in the adult population. We report a case of histologically and biochemically confirmed hyperaldosteronism related to an adrenal adenoma, where initial screening and biochemical tests were potentially misleading. The case highlights the importance of clinical suspicion in the current diagnostic approach to primary hyperaldosteronism. Read More
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    Clinical Utility of the Adrenocorticotropin Stimulation Test with/without Dexamethasone Suppression for Definitive and Subtype Diagnosis of Primary Aldosteronism.
    Int J Mol Sci 2017 Apr 30;18(5). Epub 2017 Apr 30.
    Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan.
    The adrenocorticotropin (ACTH) stimulation test (AST) has been reported to be useful for diagnosing primary aldosteronism (PA), particularly for differentiating PA subtypes under 1-mg dexamethasone suppression (DS). The aim of our study was to clarify the effect of 1-mg DS on AST results. A retrospective cohort study was conducted using data for 48 patients (PA: 30/48). Read More
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    Outcomes analysis of surgical and medical treatments for patients with primary aldosteronism.
    Endocr J 2017 Jun 29;64(6):623-632. Epub 2017 Apr 29.
    Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
    Patients with aldosterone-producing adenomas are treated using surgery, and patients with idiopathic hyperaldosteronism receive medical treatment using mineralocorticoid receptor antagonists (MRAs). However, the outcomes of surgical and medical treatment for primary aldosteronism (PA) remain unclear. Therefore, we compared the outcomes of surgical and medical treatment for PA and aimed to identify a specific subgroup that might benefit from medical treatment. Read More
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    Familial hyperaldosteronism type III.
    J Hum Hypertens 2017 Apr 27. Epub 2017 Apr 27.
    Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy.
    Primary aldosteronism is the most common form of endocrine hypertension. This disorder comprises both sporadic and familial forms. Four familial forms of primary aldosteronism (FH-I to FH-IV) have been described. Read More
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    Subtype Diagnosis of Primary Aldosteronism: Is Adrenal Vein Sampling Always Necessary?
    Int J Mol Sci 2017 Apr 17;18(4). Epub 2017 Apr 17.
    Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Via Genova 3, 10126 Torino, Italy.
    Aldosterone producing adenoma and bilateral adrenal hyperplasia are the two most common subtypes of primary aldosteronism (PA) that require targeted and distinct therapeutic approaches: unilateral adrenalectomy or lifelong medical therapy with mineralocorticoid receptor antagonists. According to the 2016 Endocrine Society Guideline, adrenal venous sampling (AVS) is the gold standard test to distinguish between unilateral and bilateral aldosterone overproduction and therefore, to safely refer patients with PA to surgery. Despite significant advances in the optimization of the AVS procedure and the interpretation of hormonal data, a standardized protocol across centers is still lacking. Read More
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    Somatic and inherited mutations in primary aldosteronism.
    J Mol Endocrinol 2017 Jul 11;59(1):R47-R63. Epub 2017 Apr 11.
    INSERMUMRS_970, Paris Cardiovascular Research Center, Paris, France.
    Primary aldosteronism (PA), the most common form of secondary hypertension, is caused in the majority of cases by unilateral aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia. Over the past few years, somatic mutations in KCNJ5, CACNA1D, ATP1A1 and ATP2B3 have been proven to be associated with APA development, representing more than 50% of sporadic APA. The identification of these mutations has allowed the development of a model for APA involving modification on the intracellular ionic equilibrium and regulation of cell membrane potential, leading to autonomous aldosterone overproduction. Read More
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    Adrenal venous sampling in a patient with left inferior vena cava.
    Clin Case Rep 2017 Apr 2;5(4):482-485. Epub 2017 Mar 2.
    Department of Cardiovascular Medicine JR Hiroshima Hospital 3-1-36 Futabanosato Higashi-ku Hiroshima 732-0057 Japan.
    Adrenal venous sampling (AVS), although difficult, is recommended for patients with primary aldosteronism (PA) to diagnose the subtype. Recognizing anatomical variation is key to a successful AVS. We report on a patient with PA and left inferior vena cava (IVC) whose left adrenal vein drained directly into the IVC. Read More
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    Histopathological Classification of Cross-Sectional Image-Negative Hyperaldosteronism.
    J Clin Endocrinol Metab 2017 Apr;102(4):1182-1192
    Department of Pathology, and.
    Context: Approximately half of patients with primary aldosteronism (PA) have clinically evident disease according to clinical (hypertension) and/or laboratory (aldosterone and renin levels) findings but do not have nodules detectable in routine cross-sectional imaging. However, the detailed histopathologic, steroidogenic, and pathobiological features of cross-sectional image-negative PA are controversial.

    Objective: To examine histopathology, steroidogenic enzyme expression, and aldosterone-driver gene somatic mutation status in cross-sectional image-negative hyperaldosteronism. Read More
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    Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practice.
    J Am Coll Cardiol 2017 Apr;69(14):1811-1820
    Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy. Electronic address:
    Background: Despite being widely recognized as the most common form of secondary hypertension, among the general hypertensive population the true prevalence of primary aldosteronism (PA) and its main subtypes, aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH), remains a matter of debate.

    Objectives: This study sought to determine the prevalence and clinical phenotype of PA in a large cohort of unselected patients with hypertension, consecutively referred to our hypertension unit, by 19 general practitioners from Torino, Italy.

    Methods: Following withdrawal from all interfering medications, patients were screened for PA using the ratio of serum aldosterone to plasma renin activity. Read More
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    How to Escape from Primary Aldosteronism? News and Views on an Adrenal Disorder of Salt Retention.
    Horm Metab Res 2017 Mar 28;49(3):151-163. Epub 2017 Mar 28.
    Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany.
    The last years have seen substantial progress in primary aldosteronism (PA), which is the most common cause of secondary hypertension. Many programs have been established around the world to meet the needs in healthcare and the management of patients with PA according to published guidelines and clinical protocols. Systematic analysis of emerging data and meticulous scientific work have informed us on the molecular basis of the disease and helped to characterize hereditary forms of PA. Read More
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    AN INDIVIDUALIZED APPROACH TO THE EVALUATION AND MANAGEMENT OF PRIMARY ALDOSTERONISM.
    Endocr Pract 2017 Jun 23;23(6):680-689. Epub 2017 Mar 23.
    Objective: With the increased emphasis on personalized and individualized medicine, the American Association of Clinical Endocrinologists Adrenal Scientific Committee has developed a series of articles to update members on personalized medicine as it applies to adrenal diseases.

    Methods: We synthesized literature reviews, guidelines from professional societies, and personal experience.

    Results: Since Conn described primary aldosteronism (PA) over 60 years ago, debate has raged about the prevalence of PA in the hypertensive population, the wisdom of broadly screening for PA, and prudent approaches to evaluate and manage these patients. Read More
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    PENTRAXIN 3 AS A NEW CARDIOVASCULAR MARKER IN ADRENAL ADENOMAS.
    Endocr Pract 2017 Jun 23;23(6):662-668. Epub 2017 Mar 23.
    Objective: Pentraxin 3 (PTX3) is an acute-phase glycoprotein, which is increased in patients with cardiovascular disease (CVD) and considered as a predictor of CVD in the general population. Both functional and nonfunctional adrenal tumors are associated with a higher risk of cardiovascular events and mortality. We aimed to investigate plasma PTX3 levels in patients with functioning and nonfunctioning adrenal tumors and determine its relationship with cardiovascular risk factors. Read More
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    Renin angiotensin aldosterone system altered in resistant hypertension in Sub-Saharan African diabetes patients without evidence of primary hyperaldosteronism.
    JRSM Cardiovasc Dis 2017 Jan-Dec;6:2048004017695006. Epub 2017 Feb 1.
    Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon; National Obesity Centre, Diabetes and Metabolic Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon.
    Background: The renin-angiotensin-aldosterone system may be altered in patients with resistant hypertension. This study aimed to evaluate the relation between renin-angiotensin-aldosterone system activity and resistant hypertension in Cameroonian diabetes patients with resistant hypertension.

    Methods: We carried out a case-control study including 19 diabetes patients with resistant hypertension and 19 diabetes patients with controlled hypertension matched to cases according to age, sex and duration of hypertension since diagnosis. Read More
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    A Comprehensive Guide to the MAGE Family of Ubiquitin Ligases.
    J Mol Biol 2017 Apr 11;429(8):1114-1142. Epub 2017 Mar 11.
    Department of Cell and Molecular Biology, St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA. Electronic address:
    Melanoma antigen (MAGE) genes are conserved in all eukaryotes and encode for proteins sharing a common MAGE homology domain. Although only a single MAGE gene exists in lower eukaryotes, the MAGE family rapidly expanded in eutherians and consists of more than 50 highly conserved genes in humans. A subset of MAGEs initially garnered interest as cancer biomarkers and immunotherapeutic targets due to their antigenic properties and unique expression pattern that is primary restricted to germ cells and aberrantly reactivated in various cancers. Read More
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    Acid-base disturbances in nephrotic syndrome: analysis using the CO2/HCO3 method (traditional Boston model) and the physicochemical method (Stewart model).
    Clin Exp Nephrol 2017 Mar 13. Epub 2017 Mar 13.
    Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
    Background: The Stewart model for analyzing acid-base disturbances emphasizes serum albumin levels, which are ignored in the traditional Boston model. We compared data derived using the Stewart model to those using the Boston model in patients with nephrotic syndrome.

    Methods: Twenty-nine patients with nephrotic syndrome and six patients without urinary protein or acid-base disturbances provided blood and urine samples for analysis that included routine biochemical and arterial blood gas tests, plasma renin activity, and aldosterone. Read More
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    Continuum of Renin-Independent Aldosteronism in Normotension.
    Hypertension 2017 May 13;69(5):950-956. Epub 2017 Mar 13.
    From the Program for Adrenal Disorders and Endocrine Hypertension, Department of Endocrinology, School of Medicine, Pontificia Universidad Catolica De Chile, Santiago (R.B., F.J.G., C.F.); and Division of Renal Medicine (G.H.) and Center for Adrenal Disorders, Division of Endocrinology, Diabetes and Hypertension (J.B., G.W., A.V.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
    Primary aldosteronism is a severe form of autonomous aldosteronism. Milder forms of autonomous and renin-independent aldosteronism may be common, even in normotension. We characterized aldosterone secretion in 210 normotensives who had suppressed plasma renin activity (<1. Read More
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    Hypokalemia and Pendrin Induction by Aldosterone.
    Hypertension 2017 May 13;69(5):855-862. Epub 2017 Mar 13.
    From the Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan (N.X., K.I., S.U., S.S.); Department of Nephrology, Tianjin First Central Hospital, China (N.X., W.X.C.); and Division of Clinical Epigenetics, Research Center for Advanced Science and Technology (D.H., T.F., S.S.) and Department of Clinical Laboratory, School of Medicine (T.S.), The University of Tokyo, Japan.
    Aldosterone plays an important role in regulating Na-Cl reabsorption and blood pressure. Epithelial Na(+) channel, Na(+)-Cl(-) cotransporter, and Cl(-)/HCO3(-) exchanger pendrin are the major mediators of Na-Cl transport in the aldosterone-sensitive distal nephron. Existing evidence also suggests that plasma K(+) concentration affects renal Na-Cl handling. Read More
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    Licorice-induced hypertension: a case of pseudohyperaldosteronism due to jelly bean ingestion.
    Postgrad Med 2017 Apr 15;129(3):329-331. Epub 2017 Feb 15.
    d Division of Endocrinology and Metabolism , St. Joseph's Health Care , London , Canada.
    Hypertension is one of the most common problems encountered in the primary care setting. Numerous secondary causes of hypertension exist and are potentially reversible. The ability to screen for such causes and manage them effectively may spare patients from prolonged medical therapy and hypertensive complications. Read More
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    A case of primary aldosteronism caused by unilateral multiple adrenocortical micronodules presenting as muscle cramps at rest: The importance of functional histopathology for identifying a culprit lesion.
    Pathol Int 2017 Apr 5;67(4):214-221. Epub 2017 Mar 5.
    Department of Diagnostic Pathology, Jichi Medical University Hospital, Shimotsuke, Japan.
    Unilateral multiple adrenocortical micronodules (UMNs) constitute a rare subset of primary aldosteronism (PA) characterized by the hypersecretion of aldosterone derived from multiple small nodules in the zona glomerulosa of the unilateral adrenal grand. This case study describes a 49-year-old man with PA and UMNs who presented with muscle cramps at rest due to hypokalemia. The patient had a 6-year history of hypertension treated with antihypertensive drugs. Read More
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    [Long-term blood pressure outcome after unilateral adrenalectomy for primary hyperaldosteronism].
    Prog Urol 2017 May 1;27(6):389-394. Epub 2017 Mar 1.
    Service d'endocrinologie, maladies métaboliques, diabétologie et nutrition, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
    Objectives: To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify prognostic factors associated.

    Methods: Exhaustive retrospective review of all consecutive patients undergoing adrenalectomy for PA between 2002 and 2013 in our department. All patients underwent preoperative: clinical evaluation (age, sex, height, weight, systolic and diastolic BP under treatment, identification of anti-hypertension treatment), biological evaluation (potassium, renin, aldosterone) and radiological evaluation (CT and/or MRI). Read More
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    Radiofrequency ablation treatment for aldosterone-producing adenomas.
    Curr Opin Endocrinol Diabetes Obes 2017 Jun;24(3):169-173
    Division of Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
    Purpose Of Review: To review the current status of radiofrequency ablation as a primary treatment for hyperfunctioning adrenal nodules, predominantly aldosterone-producing adenomas (APAs).

    Recent Findings: Radiofrequency ablation is an established treatment for focal benign and malignant lesions, including metastatic disease to the adrenal gland. Hyperaldosteronism is the leading cause of secondary hypertension with up to 80% due to APA, statistically the most common functioning adrenal nodule. Read More
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    Transarterial embolization of a hyperfunctioning aldosteronoma in a patient with bilateral adrenal nodules.
    Radiol Case Rep 2017 Mar 29;12(1):87-91. Epub 2016 Nov 29.
    Department of Vascular and Interventional Radiology, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL 33136-1005, USA.
    Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. Read More
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    NP-59 test for preoperative localization of primary hyperaldosteronism.
    Langenbecks Arch Surg 2017 Mar 21;402(2):303-308. Epub 2017 Feb 21.
    University Hospital La Princesa, Madrid, Spain.
    Purpose: Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases.

    Methods: Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. Read More
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    Low dose-eplerenone treatment decreases aortic stiffness in patients with resistant hypertension.
    J Clin Hypertens (Greenwich) 2017 Jul 17;19(7):669-676. Epub 2017 Feb 17.
    Divisions of Nephrology and Intensive Care Medicine, Department of Internal Medicine, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
    Vascular damage is aggravated in animal models of hypertension with mineralocorticoid (MR) excess and in hypertensive patients with primary hyperaldosteronism. MR antagonism has shown to provide effective blood pressure (BP)-control in patients with treatment resistant hypertension (TRH), but the concurrent effects on the vasculature have not been examined. In a randomized, double-blinded, placebo-controlled parallel-group study, 51 patients with TRH received either eplerenone 50 mg or placebo for 6 months together with additional antihypertensives titrated to achieve a BP target of <140/90 mm Hg. Read More
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    Increased Aldosterone Release During Head-Up Tilt in Early Primary Hypertension.
    Am J Hypertens 2017 May;30(5):484-489
    Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
    Background: Hyperaldosteronism is well known cause of secondary hypertension. However, the importance of aldosterone for the much larger group of patients with primary hypertension is less clear. We hypothesized that in young subjects with primary hypertension, the rise of plasma aldosterone levels in response to head-up tilt testing as a stress stimulus is exaggerated. Read More
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    Primary Aldosteronism as a Risk Factor for Vertebral Fracture.
    J Clin Endocrinol Metab 2017 Apr;102(4):1237-1243
    Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan, and.
    Context: Some observational studies have revealed an association between excessive aldosterone levels and reduced bone mineral density (BMD). However, whether patients with primary aldosteronism (PA) are at higher risk of fracture than healthy individuals remains unclear.

    Objective: This study aimed to clarify whether PA represents a risk factor for vertebral fracture (VF). Read More
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    Stroke disclosing primary aldosteronism: Report on three cases and review of the literature.
    Ann Endocrinol (Paris) 2017 Feb 4;78(1):9-13. Epub 2017 Feb 4.
    Department of Neurology, Military Hospital, 1008, Montfleury, 1089 Tunis, Tunisia.
    Objectives: There is a growing evidence of increased risk of cerebrovascular events in primary aldosteronism (PA). Nevertheless, acute neurologic ailment as presenting feature of PA is uncommon. Our aim is to highlight the diagnosis challenges in stroke unmasking PA and to discuss the underlying physiopathology and management dilemmas. Read More
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    Anatomical Variations of the Right Adrenal Vein: Concordance Between Multidetector Computed Tomography and Catheter Venography.
    Hypertension 2017 Mar 30;69(3):428-434. Epub 2017 Jan 30.
    From the Department of Diagnostic Radiology (K.O., H.O., Y.T., T.M., K.S., K.T.), Department of Urology (Y.A.), and Division of Nephrology, Endocrinology, and Vascular Medicine (R.M., F.S.), Tohoku University Hospital, Sendai, Japan.
    Adrenal venous sampling is the most reliable diagnostic procedure to determine surgical indications in primary aldosteronism. Because guidelines recommend multidetector computed tomography (CT) to evaluate the adrenal gland, some past reports used multidetector CT as a guide for adrenal venous sampling. However, the detailed anatomy of the right adrenal vein and its relationship with an accessory hepatic vein remains uncertain. Read More
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    Novel Approach to Establishing an Aldosterone: Renin Ratio Cutoff for Primary Aldosteronism.
    Hypertension 2017 Mar 9;69(3):450-456. Epub 2017 Jan 9.
    From the Division of Endocrinology and Metabolism, Department of Medicine (A.A.L., G.A.K.) and Calgary Laboratory Services, Department of Pathology and Laboratory Medicine, Section of Clinical Biochemistry (D.J.O., A.C., H.S.), University of Calgary, Alberta, Canada.
    Direct renin concentration is replacing plasma renin activity in many laboratories for the investigation of primary aldosteronism, which may have a significant impact on the resulting aldosterone:renin ratios. We sought to develop a population-based approach to establishing an aldosterone:renin ratio cutoff when transitioning between assays. A population-based study was performed in Calgary, Alberta, Canada of 4301 individuals who received testing from January 2012 to November 2015. Read More
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    Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Hyperaldosternoism: A Case Report.
    Am J Case Rep 2017 Jan 4;18:12-16. Epub 2017 Jan 4.
    Department of Medicine, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan.
    BACKGROUND Thyrotoxic periodic paralysis (TPP) is commonly observed in patients with acute paralysis and hyperthyroidism. However, there is a possibility of secondary causes of hypokalemia in such a setting. CASE REPORT Herein, we present the case of a 38-year-old woman with untreated hypertension and hyperthyroidism. Read More
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    Synthetic approaches towards the multi target drug spironolactone and its potent analogues/derivatives.
    Steroids 2017 Feb 29;118:76-92. Epub 2016 Dec 29.
    Department of Chemistry, Quaid-i-Azam University, 45320 Islamabad, Pakistan.
    Spironolactone is a well-known multi-target drug and is specifically used for the treatment of high blood pressure and heart failure. It is also used for the treatment of edema, cirrhosis of the liver, malignant, pediatric, nephrosis and primary hyperaldosteronism. Spironolactone in association with thiazide diuretics treats hypertension and in association with furosemide treats bronchopulmonary dyspepsia. Read More
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    Digenic mutations involving both the BSND and GJB2 genes detected in Bartter syndrome type IV.
    Int J Pediatr Otorhinolaryngol 2017 Jan 26;92:17-20. Epub 2016 Oct 26.
    Department of Otolaryngology, Head & Neck Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. Electronic address:
    Bartter syndrome type IV, characterized by salt-losing nephropathies and sensorineural deafness, is caused by mutations of BSND or simultaneous mutations of both CLCNKA and CLCNKB. GJB2 is the primary causative gene for non-syndromic sensorineural deafness and associated with several syndromic sensorineural deafness. Owing to the rarity of Bartter syndrome, only a few mutations have been reported in the abovementioned causative genes. Read More
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    Improvement of Bone Turnover Markers and Bone Mineral Density following treatment of Primary Aldosteronism.
    Minerva Endocrinol 2016 Dec 20. Epub 2016 Dec 20.
    Endocrine Unit, Department of Medicine, University Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia -
    Background: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension.

    Methods: This was an open-label, prospective, case-controlled study, conducted over 12 months. Read More
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    Genetic characterization of a mouse line with primary aldosteronism.
    J Mol Endocrinol 2017 Feb 13;58(2):67-78. Epub 2016 Dec 13.
    Medizinische Klinik und Poliklinik IVEndocrine Research Unit, Klinikum der Universität München, LMU, Munich, Germany.
    In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism, a mutagenesis screen after treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. Read More
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    A Novel Method of Adrenal Venous Sampling via an Antecubital Approach.
    Cardiovasc Intervent Radiol 2017 Mar 8;40(3):388-393. Epub 2016 Dec 8.
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing, 100037, China.
    Purpose: Currently, almost all adrenal venous sampling (AVS) procedures are performed by femoral vein access. The purpose of this study was to establish the technique of AVS via an antecubital approach and evaluate its safety and feasibility.

    Materials And Methods: From January 2012 to June 2015, 194 consecutive patients diagnosed as primary aldosteronism underwent AVS via an antecubital approach without ACTH simulation. Read More
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    Plasma adrenocorticotropic hormone but not aldosterone is correlated with blood pressure in patients with aldosterone-producing adenomas.
    J Clin Hypertens (Greenwich) 2017 Mar 5;19(3):280-286. Epub 2016 Dec 5.
    Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
    Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. Read More
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    PREVELENCE OF PRIMARY ALDOSTERONISM IN AN URBAN HYPERTENSIVE POPULATION.
    Endocr Pract 2016 Nov;22(11):1296-1302
    Objective: To determine the prevalence of primary aldosteronism (PA) in hypertensive patients presenting to the primary care clinic at The Mount Sinai Hospital, regardless of the degree of hypertension and to identify clinical criteria that should prompt screening for PA.

    Methods: An aldosterone:renin ratio (ARR, cutoff ≥20, with plasma aldosterone concentration [PAC] ≥10 and suppressed renin) was used to prospectively screen 296 hypertensive patients (blood pressure [BP] ≥140/90) over the age of 18 from August 2012 through May 2013. Subjects who screened positive then underwent confirmatory oral salt load testing (OSLT). Read More
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