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    3890 results match your criteria Hyperaldosteronism Primary

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    Adrenocortical development: Lessons from mouse models.
    Ann Endocrinol (Paris) 2018 Apr 16. Epub 2018 Apr 16.
    GReD, CNRS, Inserm, université Clermont-Auvergne, 63001 Clermont-Ferrand, France. Electronic address:
    The adrenocortical gland undergoes structural and functional remodelling in the fetal and postnatal periods. After birth, the fetal zone of the gland undergoes rapid involution in favor of the definitive cortex, which reaches maturity with the emergence of the zona reticularis(zR) at the adrenarche. The mechanisms underlying the adrenarche, the process leading to pre-puberty elevation of plasma androgens in higher primates, remain unknown, largely due to lack of any experimental model. Read More

    Comparative Genomics and Transcriptome Profiling in Primary Aldosteronism.
    Int J Mol Sci 2018 Apr 9;19(4). Epub 2018 Apr 9.
    Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, 80336 Munich, Germany.
    Primary aldosteronism is the most common form of endocrine hypertension with a prevalence of 6% in the general population with hypertension. The genetic basis of the four familial forms of primary aldosteronism (familial hyperaldosteronism FH types I-IV) and the majority of sporadic unilateral aldosterone-producing adenomas has now been resolved. Familial forms of hyperaldosteronism are, however, rare. Read More

    Bone Health in Adrenal Disorders.
    Endocrinol Metab (Seoul) 2018 Mar;33(1):1-8
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
    Secondary osteoporosis resulting from specific clinical disorders may be potentially reversible, and thus continuous efforts to find and adequately treat the secondary causes of skeletal fragility are critical to ameliorate fracture risk and to avoid unnecessary treatment with anti-osteoporotic drugs. Among the hyperfunctional adrenal masses, Cushing's syndrome, pheochromocytoma, and primary aldosteronism are receiving particularly great attention due to their high morbidity and mortality mainly by increasing cardiovascular risk. Interestingly, there is accumulating experimental and clinical evidence that adrenal hormones may have direct detrimental effects on bone metabolism as well. Read More

    Hypertensive crisis with 2 target organ impairment induced by glycyrrhizin: A case report.
    Medicine (Baltimore) 2018 Mar;97(11):e0073
    Department of Endocrinology and Metabolism.
    Rationale: Glycyrrhizin is the main active component of licorice. Licorice and glycyrrhizin induced hypertension has been widely reported, yet licorice and glycyrrhizin induced hypertensive crisis has been rarely known.

    Patient Concerns: The case of this report was a 47-year-old woman, who took 225 mg of glycyrrhizin daily for 3 years due to primary biliary cholangitis. Read More

    Update in adrenal venous sampling for primary aldosteronism.
    Curr Opin Endocrinol Diabetes Obes 2018 Mar 7. Epub 2018 Mar 7.
    Clinica dell'Ipertensione Arteriosa, Department of Medicine - DIMED - University of Padova, Padova, Italy.
    Purpose Of Review: Current guidelines recommend adrenal venous sampling (AVS) to identify the surgically curable causes of hyperaldosteronism. In contrast with this recommendation, AVS remains markedly underutilized in clinical practice, which leads to deny curative adrenalectomy, to many patients with primary aldosteronism. The purpose of this review is to challenge the views that AVS is a technically challenging, invasive and risky procedure, which moreover, is difficult to interpret. Read More

    Anomalous adrenal vein anatomy complicating the evaluation of primary hyperaldosteronism.
    Radiol Case Rep 2018 Feb 20;13(1):139-141. Epub 2017 Oct 20.
    Department of Interventional Radiology, Yale New Haven Hospital, New Haven, CT, USA.
    Adrenal vein development in utero occurs concurrently with the development of the inferior vena cava, the renal veins, and the gonadal veins. The embryologic formation of these veins involves communication of various venous systems. Although the left adrenal-renal vein complex is most commonly described as a shared emptying of the left adrenal vein and the left inferior phrenic vein into the left renal vein, there have been reports of numerous anatomic variations of this complex. Read More

    Adrenalectomy Lowers Incident Atrial Fibrillation in Primary Aldosteronism Patients at Long Term.
    Hypertension 2018 Apr 26;71(4):585-591. Epub 2018 Feb 26.
    From the Clinica dell'Ipertensione Arteriosa Department of Medicine - DIMED, University of Padua, Italy.
    Primary aldosteronism (PA) causes cardiovascular damage in excess to the blood pressure elevation, but there are no prospective studies proving a worse long-term prognosis in adrenalectomized and medically treated patients. We have, therefore, assessed the outcome of PA patients according to treatment mode in the PAPY study (Primary Aldosteronism Prevalence in Hypertension) patients, 88.8% of whom were optimally treated patients with primary (essential) hypertension (PH), and the rest had PA and were assigned to medical therapy (6. Read More

    Accuracy of adrenal computed tomography in predicting the unilateral subtype in young patients with hypokalaemia and elevation of aldosterone in primary aldosteronism.
    Clin Endocrinol (Oxf) 2018 May 13;88(5):645-651. Epub 2018 Mar 13.
    Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
    Context: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature.

    Objective: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone. Read More

    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

    The angiotensin type 2 receptor in the human adrenocortical zona glomerulosa and in aldosterone-producing adenoma: low expression and no functional role.
    Clin Sci (Lond) 2018 Mar 20;132(6):627-640. Epub 2018 Mar 20.
    Clinica dell'Ipertensione Arteriosa, Department of Medicine-DIMED, University of Padova, Italy
    The angiotensin II (Ang II) type 2 receptor (AT2R) and the angiotensin-(1-7) (Ang-(1-7)) receptor (MasR) play a cardiovascular protective role by counter-regulating Ang II type 1 receptor (AT1R)-mediated effects, but whether this involves blunting of adrenocortical hormone secretion is unknown. We investigated the presence of AT1R, AT2R, and MasR in aldosterone-producing adenoma (APA), a condition featuring hyperaldosteronism, and in APA-adjacent tissue. The effect of Compound 21 (C21), an AT2R agonist, on CYP11B1 (cortisol synthase) and CYP11B2 (aldosterone synthase) gene expression in NCI-H295R and HAC15 cell lines, and in APA and APA-adjacent tissue, was also assessed using the AT1R antagonist irbesartan to ascertain the specificity of C21 effect. Read More

    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 Mar 5;50(3):349-354. 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

    Development of new preclinical models to advance adrenocortical carcinoma research.
    Endocr Relat Cancer 2018 Apr 25;25(4):437-451. Epub 2018 Jan 25.
    Division of EndocrinologyMetabolism and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
    Adrenocortical cancer (ACC) is an orphan malignancy that results in heterogeneous clinical phenotypes and molecular genotypes. There are no curative treatments for this deadly cancer with 35% survival at five years. Our understanding of the underlying pathobiology and our ability to test novel therapeutic targets has been limited due to the lack of preclinical models. Read More

    ARMC5 mutations in familial and sporadic primary bilateral macronodular adrenal hyperplasia.
    PLoS One 2018 25;13(1):e0191602. Epub 2018 Jan 25.
    Department of Urology, Peking University First Hospital, Xicheng District, Beijing, China.
    To investigate Armadillo repeat-containing 5 (ARMC5) mutations in Chinese patients with familial and sporadic primary bilateral macronodular adrenal hyperplasia (PBMAH), we performed clinical data collection and ARMC5 sequencing for three PBMAH families and 23 sporadic PBMAH patients. ARMC5 pathogenic germline mutations were identified in all 3 PBMAH families. Secondary ARMC5 somatic mutations were found in two adrenal nodules from two PBMAH family members with ARMC5 germline mutations. 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 Mar 18;178(3):R101-R111. Epub 2018 Jan 18.
    Division of Internal Medicine and Hypertension UnitDepartment 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 01;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 01 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 2018 Mar;103(3):900-908
    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 the 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 02;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 , , , and genes as causes of aldosterone-producing adenomas (APAs), and the recognition of three novel hyperaldosteronism syndromes with germline variants in the , , and genes. The description of somatic variants in and in aldosterone-producing cell clusters (APCCs) suggests that these clusters are precursors of some aldosterone-producing adenomas. Read More

    Inflammation and Fibrosis in Perirenal Adipose Tissue of Patients With Aldosterone-Producing Adenoma.
    Endocrinology 2018 01;159(1):227-237
    Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
    The prevalence of primary aldosteronism is much higher than previously thought. Recent studies have shown that primary aldosteronism is related to a higher risk of cardiovascular events. However, the underlying mechanism is not yet clear. 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 Mutated 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 (CD56 cells) from APA tissues with/without the 2 most common mutations. 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.).

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