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    3823 results match your criteria Hyperaldosteronism Primary

    1 OF 77

    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.
    Objective: To investigate the clinical value of tumor size in the evaluation of endocrinological and histological natures regarding adrenal incidentaloma (AI) patients. Methods: 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.
    Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: 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

    An unusual case of Takotsubo syndrome with hyperaldosteronism as the potential cause.
    J Clin Endocrinol Metab 2017 Oct 31. Epub 2017 Oct 31.
    West China Hospital, Sichuan University.
    Context: Catecholamine-related factors are currently the most popular explanation for the occurrence of Takotsubo syndrome. The aldosterone-related mechanism, however, has not been proposed.

    Case Description: A 45-year old male, presenting with ST-segment elevation myocardial infarction (STEMI), was finally 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 2017 Oct 27. Epub 2017 Oct 27.
    Department of Pharmacology and Toxicology Medical College of Wisconsin 8701 Watertown Plank Road Milwaukee, WI 53226.
    Hyperaldosteronism is associated with hypertension, cardiac hypertrophy, and congestive heart failure. Steroidogenic factors facilitate aldosterone secretion by increasing adrenal blood flow. Angiotensin II (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 Dec 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 Oct 23. Epub 2017 Oct 23.
    Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, 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 2017 Oct 25. Epub 2017 Oct 25.
    Department of Endocrinology, Christchurch Hospital, Private Bag 4710, 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 Oct 24. 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 KCNJ5, CACNA1D, ATP1A1, and ATP2B3 genes as causes of aldosterone-producing adenomas (APAs), and the recognition of three novel hyperaldosteronism syndromes with germline variants in the KCNJ5, CACNA1D, and CACNA1H genes. The description of somatic variants in CACNA1D and ATP1A1 in 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 in KCNJ5 Mutated Adenoma Cells Ex Vivo.
    Hypertension 2017 Dec 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 (KCNJ5) 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 (CD56(+) cells) from APA tissues with/without the 2 most common KCNJ5 mutations. Read More

    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 2017 Sep 13. Epub 2017 Sep 13.
    C Gomez-Sanchez, Endocrinology, University of Mississippi Medical Center, Jackson, 39216, United States.
    Since the early nineteen eighties 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

    [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 the SLC12A3 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

    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

    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 Dec 4;27(12):5006-5014. 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

    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

    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

    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

    [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

    Primary aldosteronism: a common cause of resistant hypertension.
    CMAJ 2017 06;189(22):E773-E778
    Department of Endocrinology (Kline, Leung), University of Calgary, Calgary, Alta.; Department of Internal Medicine, Endocrinology and Metabolism (Prebtani), McMaster University, Hamilton, Ont.; Department of Medicine (Schiffrin), Jewish General Hospital and Lady Davis Research Institute, McGill University, Montréal, Que.

    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

    NEFM (Neurofilament Medium) Polypeptide, a Marker for Zona Glomerulosa Cells in Human Adrenal, Inhibits D1R (Dopamine D1 Receptor)-Mediated Secretion of Aldosterone.
    Hypertension 2017 Aug 5;70(2):357-364. Epub 2017 Jun 5.
    From the Clinical Pharmacology Unit, Department of Medicine (C.M., S.G., J.Z.) and Medical Research Council Cancer Unit (T.I.J.), University of Cambridge, United Kingdom; Human Research Tissue Bank, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, United Kingdom (W.Z.); Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Cambridge, United Kingdom (M.G.); and the Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (J.Z., M.J.B.).
    Heterogeneity among aldosterone-producing adenomas (APAs) has been highlighted by the discovery of somatic mutations. KCNJ5 mutations predominate in large zona fasciculata (ZF)-like APAs; mutations in CACNA1D, ATP1A1, ATP2B3, and CTNNB1 are more likely to be found in small zona glomerulosa (ZG)-like APAs. Microarray comparison of KCNJ5 mutant versus wild-type APAs revealed significant differences in transcriptomes. Read More

    Androstenedione and 17-α-Hydroxyprogesterone Are Better Indicators of Adrenal Vein Sampling Selectivity Than Cortisol.
    Hypertension 2017 Aug 5;70(2):342-346. Epub 2017 Jun 5.
    From the Clinica dell'Ipertensione Arteriosa (G.C., G.M., M.C., G.R., V.B., G.P.R.) and Laboratory Medicine (G.A., M.P.), Department of Medicine, DIMED-University of Padua, Italy.
    For identification of potentially surgically curable primary aldosteronism, guidelines recommend use of adrenal vein sampling (AVS) that requires selective catheterization of both adrenal veins as verified by using the cortisol-derived selectivity index. Unfortunately, bilaterally selective studies are not obtained under unstimulated conditions in a proportion of the cases ranging between 15% and 50% depending on the cutoff used. We therefore investigated whether 17-α-hydroxyprogesterone and androstenedione, which showed a higher step-up between adrenal vein and inferior vena cava blood than cortisol, can ascertain selectivity when cortisol failed to do so. Read More

    Age-Related Autonomous Aldosteronism.
    Circulation 2017 Jul 31;136(4):347-355. Epub 2017 May 31.
    From Departments of Molecular and Integrative Physiology & Internal Medicine, University of Michigan, Ann Arbor (K.N., I.Z., W.E.R.); Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V., G.H.W.); and Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor (T.E., W.E.R.).
    Background: Both aging and inappropriate secretion of aldosterone increase the risk for developing cardiovascular disease; however, the influence of aging on aldosterone secretion and physiology is not well understood.

    Methods: The relationship between age and adrenal aldosterone synthase (CYP11B2) expression was evaluated in 127 normal adrenal glands from deceased kidney donors (age, 9 months to 68 years). Following immunohistochemistry, CYP11B2-expressing area and areas of abnormal foci of CYP11B2-expressing cells, called aldosterone-producing cell clusters, were analyzed. Read More

    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

    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

    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

    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

    Familial hyperaldosteronism type III.
    J Hum Hypertens 2017 Dec 27;31(12):776-781. 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

    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

    Physiological and Pathological Roles in Human Adrenal of the Glomeruli-Defining Matrix Protein NPNT (Nephronectin).
    Hypertension 2017 Jun 17;69(6):1207-1216. Epub 2017 Apr 17.
    From the Clinical Pharmacology Unit, Centre for Clinical Investigation, Addenbrooke's Hospital (A.E.D.T., S.G., J.Z., M.J.B.), Tissue Bank, Department of Histopathology, Addenbrooke's Hospital (W.Z.), NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital (M.G.), MRC Cancer Unit, Hutchison/MRC Research Centre (T.I.J.), and Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science (M.G.), University of Cambridge, United Kingdom; Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, United Kingdom (J.Z., M.J.B.); Division of Endocrinology, Department of Medicine, The University of Mississippi Medical Centre, Jackson (C.E.G.-S.); and Research and Medicine Services, G.V. (Sonny) Montgomery VA Medical Centre, Jackson, MS (C.E.G.-S.).
    Primary aldosteronism is a common cause of hypertension, which becomes refractory if undiagnosed, but potentially curable when caused by an aldosterone-producing adenoma (APA). The discovery of somatic mutations and differences in clinical presentations led to recognition of small but common zona glomerulosa (ZG)-like adenomas, distinct from classical large zona fasciculata-like adenomas. The inverse correlation between APA size and aldosterone synthase expression prompted us to undertake a systematic study of genotype-phenotype relationships. Read More

    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

    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

    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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