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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

    Glucocorticoid-remediable aldosteronism in a young adult with a family history of Conn's syndrome.
    Clin Case Rep 2018 Feb 15;6(2):416-419. Epub 2018 Jan 15.
    Department of CardiologyKliniken an der PaarKrankenhaus AichachAichachGermany.
    Glucocorticoid-remediable aldosteronism is a hereditary form of primary hyperaldosteronism and the most common monogenic cause of hypertension. We present the case of a 24-year-old man with a family history of Conn's syndrome. Yet, in the index patient, classical characteristics of mineralocorticoid excess could be reversed by exogenous glucocorticoids. 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

    CLCN2 chloride channel mutations in familial hyperaldosteronism type II.
    Nat Genet 2018 Feb 5. Epub 2018 Feb 5.
    Department of Genetics, Yale University School of Medicine, New Haven, CT, USA.
    Primary aldosteronism, a common cause of severe hypertension, features constitutive production of the adrenal steroid aldosterone. We analyzed a multiplex family with familial hyperaldosteronism type II (FH-II)and 80 additional probands with unsolved early-onset primary aldosteronism. Eight probands had novel heterozygous variants in CLCN2, including two de novo mutations and four independent occurrences of a mutation encoding an identical p. Read More

    Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism: A Multicenter Study in Japan.
    Hypertension 2018 Mar 22;71(3):530-537. Epub 2018 Jan 22.
    From the Department of Diabetes, Endocrinology, and Nutrition (Y. Ohno, M.S., N.I.) and Department of Urology (T. Yamasaki, O.O.), Kyoto University, Japan; Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Japan (Y. Takeda); Department of Endocrinology, Metabolism, and Nephrology, Keio University School of Medicine, Tokyo, Japan (I.K., H.I.); Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan (H.U., M.T., M.N.); Department of Endocrinology and Metabolism, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan (T.I.); Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Japan (T. Katabami, Y. Tanaka); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Japan (N.W., Y.S.); Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Japan (T. Yoshimoto, Y. Ogawa); Department of Metabolic Medicine, Kumamoto University, Japan (J.K.); Department of Nephrology and Endocrinology, Faculty of Medicine, The University of Tokyo, Japan (K.T., M.F.); Department of Endocrinology and Diabetes, Okazaki City Hospital, Japan (M.W.); Department of Cardiology, Sanda City Hospital, Japan (Y.M.); Division of Nephrology, Hypertension, and Endocrinology, Nihon University School of Medicine, Tokyo, Japan (H.K.); Department of Endocrinology, Metabolism, Rheumatology, and Nephrology, Oita University, Yufu, Japan (H.S.); Department of Cardiology, Akashi Medical Center, Japan (K.K.); Department of Metabolic Medicine (M.O.) and Department of Geriatric and General Medicine (K.Y.), Osaka University Graduate School of Medicine, Japan; Department of Cardiology, JR Hiroshima Hospital, Japan (Y.F.); Clinical Research Institute, National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan (A.O.); Department of Endocrinology, Tenriyorozu Hospital, Tenri, Japan (S.O.); Department of Internal Medicine, Uwajima City Hospital, Japan (S.M.); Department of Internal Medicine, Matsuyama Red Cross Hospital, Japan (T.F.); Department of Endocrinology and Metabolism, Tottori University Hospital, Japan (S.I.); Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan (T. Yoneda); Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University Hospital, Japan (S.H.); Department of Endocrinology and Diabetes Mellitus, Fukuoka University Hospital, Japan (T. Yanase); Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan (T.S.); Kyoto University Health Services, Japan (T. Kawamura); and Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan (F.M., Y. Tabara).
    There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. 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

    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

    Double hit! A unique case of resistant hypertension.
    BMJ Case Rep 2017 Dec 22;2017. Epub 2017 Dec 22.
    Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, NYU School of Medicine, New York City, New York, USA.
    A middle-aged woman with obesity, hyperlipidaemia and diet-controlled diabetes was referred for resistant hypertension. Her blood pressure (BP) was uncontrolled on five medications, including a diuretic. Physical exam revealed a systolic ejection murmur, and ECHO demonstrated moderate hypertrophy. Read More

    [Functional diagnostics in endocrinology].
    Internist (Berl) 2018 Jan;59(1):38-47
    Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Campus Innenstadt, Ziemssenstraße 1, 80366, München, Deutschland.
    When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. 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.).

    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

    The E3 ubiquitin ligase Siah1 regulates adrenal gland organization and aldosterone secretion.
    JCI Insight 2017 Dec 7;2(23). Epub 2017 Dec 7.
    Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, USA.
    Primary and secondary hypertension are major risk factors for cardiovascular disease, the leading cause of death worldwide. Elevated secretion of aldosterone resulting from primary aldosteronism (PA) is a key driver of secondary hypertension. Here, we report an unexpected role for the ubiquitin ligase Siah1 in adrenal gland development and PA. Read More

    Disordered CYP11B2 Expression in Primary Aldosteronism.
    Horm Metab Res 2017 Dec 4;49(12):957-962. Epub 2017 Dec 4.
    Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.
    Primary aldosteronism is the most common type of secondary hypertension affecting 6-10% of patients with primary hypertension. PA is mainly caused by unilateral hyperaldosteronism due to an aldosterone-producing adenoma, unilateral hyperplasia with or without micronodules or bilateral zona glomerulosa hyperplasias with or without macro or micronodules. The development of antibodies against the terminal enzyme of aldosterone biosynthesis (CYP11B2) has permitted the further characterization of normal adrenals and resected adrenals from patients with primary aldosteronism. Read More

    Confirmatory Tests for the Diagnosis of Primary Aldosteronism: A Prospective Diagnostic Accuracy Study.
    Hypertension 2018 01 20;71(1):118-124. Epub 2017 Nov 20.
    From the Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University (Y.S., S.Y., W.H., J.H., Q.C., Y.W., T.L., L.M., Q.Z., S.Z., M.M., Z.W., H.Q., Q.L.) and School of Public Health and Management, Chongqing Medical University (B.P.), China; and Division of Cardiology, Department of Medicine, Pittsburgh Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, PA (D.B.).
    The diagnosis of primary aldosteronism typically requires at least one confirmatory test. The fludrocortisone suppression test is generally accepted as a reliable confirmatory test, but it is cumbersome. Evidence from accuracy studies of the saline infusion test (SIT) and the captopril challenge test (CCT) has provided conflicting results. Read More

    Ann Endocrinol (Paris) 2017 Oct;78 Suppl 1:S11-S20
    Service d'endocrinologie, hôpital Haut-Lévèque, avenue Magellan, CHU de Bordeaux, 33600 Pessac, France.
    The 2017 Endocrine Society annual meeting included several communications and debates on the conservative adrenal surgery in bilateral hereditary pheochromocytomas (BHP), bilateral adrenal macronodular hyperplasia (BAMH) and primary hyperaldosteronism (PHA). The general principle is to preserve a part of the adrenal cortex to prevent the occurrence of a definitive adrenal insufficiency. In BHP, cortical sparing surgery allows more than 50% of patients to maintain normal corticotropic function at 10 years with a low recurrence rate (~ 10%). Read More

    [Clinical value of tumor size in the evaluation of adrenal incidentalomas].
    Zhonghua Yi Xue Za Zhi 2017 Nov;97(42):3324-3328
    Department of Endocrinology, PLA Lanzhou General Hospital, Lanzhou 730030, China.
    To investigate the clinical value of tumor size in the evaluation of endocrinological and histological natures regarding adrenal incidentaloma (AI) patients.A total of 1 941 AI patients who were hospitalized in Department of Endocrinology, Chinese PLA General Hospital between January 1997 and December 2016 were retrospectively reviewed. The demographics of patients, imaging features, functional status and histological results were analyzed. Read More

    [Role of adrenal vein sampling in differential diagnosis of primary aldosteronism subtypes].
    Zhonghua Yi Xue Za Zhi 2017 Nov;97(42):3291-3296
    Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China.
    To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA).AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Read More

    Contralateral suppression of aldosterone at adrenal venous sampling predicts hyperkalemia following adrenalectomy for primary aldosteronism.
    Surgery 2018 Jan 9;163(1):183-190. Epub 2017 Nov 9.
    Department of Surgery, Mayo Clinic, Rochester, MN.
    Background: We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism.

    Methods: A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5. Read More

    An Unusual Case of Takotsubo Syndrome With Hyperaldosteronism as the Potential Cause.
    J Clin Endocrinol Metab 2018 Jan;103(1):12-15
    Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
    Context: Catecholamine-related factors are the most popular explanation for the occurrence of Takotsubo syndrome. An aldosterone-related mechanism, however, has not been proposed.

    Case Description: A 45-year-old male patient presenting with ST-segment elevation myocardial infarction was diagnosed with primary aldosteronism, severe hypokalemia, and Takotsubo syndrome. Read More

    Secondary Hypertension: Discovering the Underlying Cause.
    Am Fam Physician 2017 Oct;96(7):453-461
    University of Alberta, Edmonton, Alberta, Canada.
    Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. Read More

    Primary Hyperaldosteronism Due to Adrenocortical Adenoma: a Case Report.
    Acta Med Indones 2017 Jul;49(3):249-254
    Department of Internal Medicine Faculty of Medicine, Diponegoro University - Dr. Kariadi Hospital Semarang, Indonesia.
    Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps  and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Read More

    Significance of Computed Tomography and Serum Potassium in Predicting Subtype Diagnosis of Primary Aldosteronism.
    J Clin Endocrinol Metab 2017 Oct 6. Epub 2017 Oct 6.
    Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
    Context: The number of centers with established adrenal venous sampling (AVS) programs for subtype diagnosis of primary aldosteronism (PA) is limited.

    Objective: Aim was to develop an algorithm for AVS based on subtype prediction by computed tomography (CT) and serum potassium.

    Design: A multi-institutional retrospective cohort study in Japan. Read More

    Obligatory Metabolism of Angiotensin II to Angiotensin III for Zona Glomerulosa Cell-Mediated Relaxations of Bovine Adrenal Cortical Arteries.
    Endocrinology 2018 01;159(1):238-247
    Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin.
    Hyperaldosteronism is associated with hypertension, cardiac hypertrophy, and congestive heart failure. Steroidogenic factors facilitate aldosterone secretion by increasing adrenal blood flow. Angiotensin (Ang) II decreases adrenal vascular tone through release of zona glomerulosa (ZG) cell-derived vasodilatory eicosanoids. Read More

    Dysregulation of Aldosterone Secretion in Mast Cell-Deficient Mice.
    Hypertension 2017 12 30;70(6):1256-1263. Epub 2017 Oct 30.
    From the Normandie Université, UNIROUEN, INSERM U1239, Rouen, France (H.-G.B., J.W., S.R., C.D., I.B., H.L., E.L.); Department of Pharmacology, Institute for Biomedical Research, Rouen University Hospital, France (J.W.); Normandie Université, UNIROUEN, Rouen, France (A.A.); and Department of Endocrinology, Diabetes, and Metabolic Diseases, Institute for Research and Innovation in Biomedicine, University Hospital of Rouen, France (H.L.).
    Resident adrenal mast cells have been shown to activate aldosterone secretion in rat and man. Especially, mast cell proliferation has been observed in adrenal tissues from patients with aldosterone-producing adrenocortical adenoma. In the present study, we show that the activity of adrenal mast cells is stimulated by low-sodium diet and correlates with aldosterone synthesis in C57BL/6 and BALB/c mice. Read More

    Mouse Models of Primary Aldosteronism: From Physiology to Pathophysiology.
    Endocrinology 2017 12;158(12):4129-4138
    Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Germany.
    Primary aldosteronism (PA) is a common form of endocrine hypertension that is characterized by the excessive production of aldosterone relative to suppressed plasma renin levels. PA is usually caused by either a unilateral aldosterone-producing adenoma or bilateral adrenal hyperplasia. Somatic mutations have been identified in several genes that encode ion pumps and channels that may explain the aldosterone excess in over half of aldosterone-producing adenomas, whereas the pathophysiology of bilateral adrenal hyperplasia is largely unknown. Read More

    Characteristics of adrenal incidentalomas in a New Zealand centre.
    Intern Med J 2018 Feb;48(2):173-178
    Department of Endocrinology, Christchurch Hospital, Christchurch, New Zealand.
    Background: Management of adrenal incidentalomas (AI) is becoming more conservative, based on international data showing a low incidence of functional or malignant lesions. The clinical characteristics of AI in New Zealand are unknown. Therefore, whether the AI guidelines apply to the New Zealand population is also unknown. Read More

    Unanswered Questions in the Genetic Basis of Primary Aldosteronism.
    Horm Metab Res 2017 Dec 24;49(12):963-968. Epub 2017 Oct 24.
    Department of Nephrology, Medical School, Heinrich Heine University, University Hospital Düsseldorf, Düsseldorf, Germany.
    Over the past six years, the genetic basis of a significant fraction of primary aldosteronism (PA) cases has been solved. Breakthrough discoveries include the role of somatic variants in the,,, andgenes as causes of aldosterone-producing adenomas (APAs), and the recognition of three novel hyperaldosteronism syndromes with germline variants in the,, andgenes. The description of somatic variants inandin aldosterone-producing cell clusters (APCCs) suggests that these clusters are precursors of some aldosterone-producing adenomas. Read More

    The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension: A Cohort Study.
    Ann Intern Med 2017 Nov 10;167(9):630-641. Epub 2017 Oct 10.
    From Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Vanderbilt University, Nashville, Tennessee; University of Washington, Seattle, Washington; London School of Hygiene & Tropical Medicine, London, United Kingdom; Pontificia Universidad Católica de Chile, Santiago, Chile; and University of California San Diego and Veterans Affairs San Diego Healthcare System, San Diego, California.
    Background: Primary aldosteronism is recognized as a severe form of renin-independent aldosteronism that results in excessive mineralocorticoid receptor (MR) activation.

    Objective: To investigate whether a spectrum of subclinical renin-independent aldosteronism that increases risk for hypertension exists among normotensive persons.

    Design: Cohort study. Read More

    On the effect of hyperaldosteronism-inducing mutations in Na/K pumps.
    J Gen Physiol 2017 Nov 13;149(11):1009-1028. Epub 2017 Oct 13.
    Department of Cell Physiology and Molecular Biophysics, Center for Membrane Protein Research, Texas Tech University Health Sciences Center, Lubbock, TX
    Primary aldosteronism, a condition in which too much aldosterone is produced and that leads to hypertension, is often initiated by an aldosterone-producing adenoma within the zona glomerulosa of the adrenal cortex. Somatic mutations of ATP1A1, encoding the Na/K pump α1 subunit, have been found in these adenomas. It has been proposed that a passive inward current transported by several of these mutant pumps is a "gain-of-function" activity that produces membrane depolarization and concomitant increases in aldosterone production. Read More

    A Novel Method: Super-selective Adrenal Venous Sampling.
    J Vis Exp 2017 Sep 15(127). Epub 2017 Sep 15.
    Endocrinology & Diabetes Center, Yokohama Rosai Hospital;
    Primary aldosteronism (PA) and subclinical Cushing's syndrome (SCS) are conditions in which the adrenal glands autonomously produce excessive amounts of aldosterone and cortisol, respectively. The conventional adrenal venous sampling (cAVS) method collects blood samples from both adrenal central veins and is useful for identifying the laterality of excess hormone production in a unilateral lesion(s), as documented in PA cases. In cAVS, plasma cortisol concentrations (PCCs) are used to normalize plasma aldosterone concentrations (PACs). Read More

    Macrolides Blunt Aldosterone Biosynthesis: A Proof-of-Concept Study inMutated Adenoma Cells Ex Vivo.
    Hypertension 2017 12 9;70(6):1238-1242. Epub 2017 Oct 9.
    From the Clinica dell'Ipertensione Arteriosa, Department of Medicine, University of Padua, Italy.
    Aldosterone-producing adenoma (APA), a major subtype of primary hyperaldosteronism, the main curable cause of human endocrine hypertension, involves somatic mutations in the potassium channel Kir3.4 () in 30% to 70% of cases, typically the more florid phenotypes. Because KCNJ5 mutated channels were reported to be specifically sensitive to inhibition by macrolide antibiotics, which concentration dependently blunts aldosterone production in HAC15 transfected with the G151R and L168R mutated channel, we herein tested the effect of clarithromycin on aldosterone synthesis and secretion in a pure population of aldosterone-secreting cells obtained by immunoseparation (CD56cells) from APA tissues with/without the 2 most commonmutations. Read More

    Old and New Concepts in the Molecular Pathogenesis of Primary Aldosteronism.
    Hypertension 2017 11 3;70(5):875-881. Epub 2017 Oct 3.
    From the Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Germany (E.T.A.P., M.R., T.A.W.); and Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Italy (J.B., T.A.W.).

    Favorable surgical outcomes of aldosterone-producing adenoma based on lateralization by CT imaging and hypokalemia: a non-AVS-based strategy.
    Int Urol Nephrol 2017 Dec 16;49(12):2151-2156. Epub 2017 Sep 16.
    Endocrinology Department, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan Er Road, 58th, Guangzhou, 510080, China.
    Purpose: To test the efficacy of a strategy based on CT imaging and clinical characteristics on lateralizing origin of excess aldosterone secretion in primary aldosteronism.

    Patients And Methods: Consecutive patients with diagnosed primary hyperaldosteronism from June 2006 to July 2012 in our center underwent adrenal surgeries without pre-operational adrenal venous sampling (AVS) if all the three criteria were met: (1) round- or oval-shaped occupational lesion of low density after contrast enhancement with diameter >1 cm on CT scan was located in one adrenal gland; (2) unequivocally normal contralateral adrenal gland; (3) serum potassium level lower than 3.5 mmol/L. Read More

    DIAGNOSIS OF ENDOCRINE DISEASE: 18-Oxocortisol and 18-hydroxycortisol: is there clinical utility of these steroids?
    Eur J Endocrinol 2018 Jan 13;178(1):R1-R9. Epub 2017 Sep 13.
    Division of EndocrinologyG.V. (Sonny) Montgomery VA Medical Center and the University of Mississippi Medical Center, Jackson, Mississippi, USA.
    Since the early 1980s 18-hydroxycortisol and 18-oxocortisol have attracted attention when it was shown that the urinary excretion of these hybrid steroids was increased in primary aldosteronism. The development and more widespread use of specific assays has improved the understanding of their role in the (patho)physiology of adrenal disorders. The adrenal site of synthesis is not fully understood although it is clear that for the synthesis of 18-hydroxycortisol and 18-oxocortisol the action of both aldosterone synthase (zona glomerulosa) and 17α-hydroxylase (zona fasciculata) is required with cortisol as main substrate. Read More

    Adrenal venous sampling for primary aldosteronism: laboratory medicine best practice.
    J Clin Pathol 2017 Nov 11;70(11):911-916. Epub 2017 Sep 11.
    Department of Pathology and Laboratory Medicine, St. Paul's Hospital, Vancouver, Canada.
    Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland. For this reason, the method of choice for identifying unilateral forms of PA is selective adrenal venous sampling (AVS) followed by aldosterone and cortisol analysis on collected samples. Read More

    Biventricular Cardiac Hypertrophy in a Patient with Primary Aldosteronism and Atrial Septal Defect.
    Am J Case Rep 2017 Sep 7;18:963-971. Epub 2017 Sep 7.
    Subdivision of Cardiovascular Medicine, Department of Medicine, Medical Faculty of Diponegoro University and Dr. Kariadi General Hospital, Semarang, Indonesia.
    BACKGROUND Primary aldosteronism can be caused by adrenocortical adenoma and is usually associated with left ventricular hypertrophy. Biventricular cardiac hypertrophy and heart failure in the presence of a pre-existing atrial septal defect (ASD) are a rare association of primary aldosteronism. CASE REPORT A 33-year-old woman with resistant hypertension and refractory hypokalemia presented with signs and symptoms of heart failure. Read More

    [Expert consensus for the diagnosis and treatment of patients with Gitelman syndrome].
    • Authors:
    Zhonghua Nei Ke Za Zhi 2017 Sep;56(9):712-716
    Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the123 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. Read More

    Baseline Demographic and Clinical Characteristics of Patients with Adrenal Incidentaloma from a Single Center in China: A Survey.
    Int J Endocrinol 2017 7;2017:3093290. Epub 2017 Aug 7.
    Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
    Aim: To investigate the clinical and endocrinological characteristics of patients with adrenal incidentaloma (AI).

    Materials And Methods: This retrospective study enrolled 1941 AI patients hospitalized at the Department of Endocrinology, Chinese PLA General Hospital, Beijing, China, between January 1997 and December 2016. The patient gender, age at visits, imaging features, functional status, and histological results were analyzed. Read More

    Kidney dysfunction following adrenalectomy in autosomal dominant polycystic kidney disease complicated with primary aldosteronism: A case report.
    Exp Ther Med 2017 Aug 13;14(2):1235-1240. Epub 2017 Jun 13.
    Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
    The present study reported a case of autosomal dominant polycystic kidney disease complicated with primary aldosteronism in a 49-year-old woman. The patient was referred for refractory hypertension. Laboratory examinations revealed low potassium and renin levels. Read More

    Primary aldosteronism as a cause of secondary osteoporosis.
    Eur J Endocrinol 2017 Nov 8;177(5):431-437. Epub 2017 Aug 8.
    Endocrinology Unit
    Objective: Patients with primary aldosteronism (PA) have a high prevalence of osteoporosis (OP) and fractures (Fx). We evaluated the presence of PA in patients admitted to our metabolic bone disease outpatient clinic.

    Design: Study conducted on an in- and outpatient basis in a referral Italian endocrinology unit. Read More

    11-Deoxycortisol may be superior to cortisol in confirming a successful adrenal vein catheterization without cosyntropin: a pilot study.
    Int J Endocr Oncol 2017 May 27;4(2):75-83. Epub 2017 Apr 27.
    Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, MD 20892, USA.
    Aim: We aimed to compare the performance of nine adrenal steroids in confirming the correct catheter position during adrenal venous sampling (AVS) without cosyntropin in patients with primary hyperaldosteronism.

    Materials & Methods: A successful adrenal vein catheterization without cosyntropin was defined as the ratio of steroids from adrenal to peripheral veins being >3:1. AVS samples from four patients with primary hyperaldosteronism were analyzed. Read More

    Caveolin 1-related autophagy initiated by aldosterone-induced oxidation promotes liver sinusoidal endothelial cells defenestration.
    Redox Biol 2017 Oct 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

    A Comparison of Robotic Versus Laparoscopic Adrenalectomy in Patients With Primary Hyperaldosteronism.
    Surg Laparosc Endosc Percutan Tech 2017 Oct;27(5):391-393
    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

    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

    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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