1,063 results match your criteria Imaging in Hyperaldosteronism


Adrenal vein sampling with and without cosyntropin stimulation for detection of surgically remediable aldosteronism.

Endocrinol Diabetes Metab 2019 Apr 7;2(2):e00066. Epub 2019 Mar 7.

Department of Medicine, Division of Endocrinology and Neag Comprehensive Cancer Center UConn Health Farmington Connecticut.

Context And Objective: Bilateral adrenal vein sampling (AVS), the diagnostic standard for identifying surgically remediable aldosteronism (SRA), is commonly performed after cosyntropin stimulation (post-ACTHstim). The role of AVS without cosyntropin stimulation (pre-ACTHstim) has not been established. The selectivity index (SI), the adrenal vein (av) serum cortisol concentration divided by that in a peripheral vein, confirms av sampling. Read More

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http://dx.doi.org/10.1002/edm2.66DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458460PMC

Adrenocortical hypofunction with simultaneous primary aldosteronism: A case report.

Medicine (Baltimore) 2019 Mar;98(13):e15033

Rationale: Cases of adrenocortical hyperfunction combined with primary aldosteronism have been reported in the literature, and the underlying mechanism involves the secretion of aldosterone and glucocorticoids by a tumor or an adenoma. However, adrenocortical hypofunction and coexisting primary aldosteronism have not been reported until now. Herein, we report a case of adrenocortical hypofunction combined with primary aldosteronism. Read More

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http://dx.doi.org/10.1097/MD.0000000000015033DOI Listing
March 2019
3 Reads

Screening in adrenal tumors.

Curr Opin Oncol 2019 May;31(3):243-246

Department of Medicine, Division of Endocrinology.

Purpose Of Review: Adrenal tumors are mostly encountered as incidentalomas in patients undergoing imaging not performed for suspected adrenal disease; although the majority are benign and nonfunctioning, malignant tumors and functioning tumors need to be excluded. The purpose of this review is to highlight recent advances in the evaluation of adrenal tumors.

Recent Findings: As a consequence of increased use of technologically improved imaging techniques, the detection of adrenal incidentalomas has continued to increase. Read More

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http://dx.doi.org/10.1097/CCO.0000000000000528DOI Listing
May 2019
2 Reads

A Case of Primary Aldosteronism Due to A Primary Adrenal Adenoma Diagnosed by Segmental Adrenal Venous Sampling (S-AVS) Using a Modified Catheter System and Lateral Cine Angiography.

Am J Case Rep 2019 Feb 2;20:139-145. Epub 2019 Feb 2.

Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.

BACKGROUND Before partial adrenalectomy for primary aldosteronism due to a primary adrenal adenoma, the aldosterone-producing tumor can be localized by segmental adrenal vein sampling (S-AVS). Cardiologists, who regularly perform percutaneous coronary intervention (PCI), or coronary angioplasty with stent, may not be familiar with the technique of S-AVS. A case of the use of S-AVS is reported in a patient who presented with primary aldosteronism and a right adrenal adenoma. Read More

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http://dx.doi.org/10.12659/AJCR.913172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368131PMC
February 2019
1 Read

A simple and efficient automated cGMP-compliant radiosynthesis of [ C]metomidate using solid phase extraction cartridge purification.

J Labelled Comp Radiopharm 2019 Apr 27;62(4):190-197. Epub 2019 Feb 27.

Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.

[ C]metomidate ([ C]MTO) is a radiotracer widely used to detect disorders of adrenocortical origin by positron emission tomography (PET) imaging. [ C]MTO PET/computed tomography (PET/CT) is considered a sensitive and specific noninvasive alternative to adrenal vein sampling (AVS) in the management of primary hyperaldosteronism (PHA). Herein, we report a reliable automated procedure for the routine manufacturing of [ C]MTO in current good manufacturing practice (cGMP) conditions on the commercial Synthra MeI Loop Vessel synthesizer. Read More

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http://dx.doi.org/10.1002/jlcr.3711DOI Listing
April 2019
6 Reads
1.187 Impact Factor

Primary Aldosteronism: Present and Future.

Authors:
John W Funder

Vitam Horm 2019 23;109:285-302. Epub 2018 Dec 23.

Hudson Institute of Medical Research, Clayton, VIC, Australia; Monash University, Clayton, VIC, Australia. Electronic address:

Primary aldosteronism (PA), currently recognized to be 5-10% of hypertension, has a cardiovascular risk profile double that in age-, sex-, and blood pressure-matched essential hypertensives. Screening for PA is by determining the plasma aldosterone to renin ratio (ARR), followed by one of half a dozen confirmatory/exclusion tests. Unilateral hyperaldosteronism normally reflects an aldosterone producing adenoma; bilateral disease is the more common form, and termed idiopathic hyperaldosteronism (IHA). Read More

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http://dx.doi.org/10.1016/bs.vh.2018.10.006DOI Listing
April 2019
2 Reads

Immunohistochemistry for aldosterone synthase CYP11B2 and matrix-assisted laser desorption ionization imaging mass spectrometry for in-situ aldosterone detection.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):105-112

Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan.

Purpose Of Review: Immunohistochemistry for aldosterone synthase (CYP11B2) has markedly provided a comprehensive picture of the adrenocortical diseases, particularly primary aldosteronism. The findings from CYP11B2-immunohistochemistry are consistent with the clinical courses of most patients with primary aldosteronism. We herein review the updated pathophysiology and usefulness of the method for understanding individual patients with different subtypes of primary aldosteronism. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000487DOI Listing
March 2019
14 Reads

Rates of abnormal aldosterone/renin ratio in African-origin compared to European-origin patients: A retrospective study.

Clin Endocrinol (Oxf) 2019 Apr 25;90(4):528-533. Epub 2019 Jan 25.

Department of Endocrinology, The Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.

Introduction: The aldosterone/renin ratio is the initial screening test for primary hyperaldosteronism (PHA), but little data exists regarding ethnic variations in this.

Methods: Following clinical observation of a high prevalence of abnormal aldosterone/renin ratio (ARR) in patients of African-origin, we retrospectively reviewed all ARR measurements in a single centre over 10 years. Rates of hypokalaemia, intraventricular septal thickness (IVS, by echocardiography) and adrenal imaging were recorded when available. Read More

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http://dx.doi.org/10.1111/cen.13920DOI Listing
April 2019
7 Reads

Usefulness of Magnetic Resonance Imaging in the Diagnosis of Juxtaglomerular Cell Tumors: A Report of 10 Cases and Review of the Literature.

Am J Kidney Dis 2019 Apr 4;73(4):566-571. Epub 2018 Dec 4.

Hypertension Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France; Faculty of Medicine, Paris-Descartes University, Paris, France. Electronic address:

Juxtaglomerular cell tumors (JCTs), a rare but potentially curable cause of hypertension, are difficult to diagnose because they may be missed or misidentified as a cyst by computed tomography (CT). Their magnetic resonance imaging (MRI) pattern has not been well described. We report the clinical, biological, and radiologic features of 10 patients with JCTs. Read More

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http://dx.doi.org/10.1053/j.ajkd.2018.09.005DOI Listing
April 2019
2 Reads

Risk of sepsis in patients with primary aldosteronism.

Crit Care 2018 11 21;22(1):313. Epub 2018 Nov 21.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Background: The interaction between hyperaldosteronism and immune dysfunction has been reported and glucocorticoid co-secretion is frequently found in primary aldosteronism (PA). The aforementioned conditions raise the possibility of the infection risk; however, clinical episodes of sepsis have not been reported in PA.

Methods: Using Taiwan's National Health Insurance Research Database between 1997 and 2009, we identified PA and aldosterone-producing adenoma (APA) matched with essential hypertension (EH) at a 1:1 ratio by propensity scores. Read More

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http://dx.doi.org/10.1186/s13054-018-2239-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249889PMC
November 2018
19 Reads

Diagnostic challenges and good treatment outcomes in pediatric paraganglioma of the abdomen: A case report.

Medicine (Baltimore) 2018 Nov;97(47):e13268

Pathology Department, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, Hainan, PR China.

Rationale: Paraganglioma is a catecholamine-producing neuroendocrine tumor. Management of paraganglioma including its diagnosis is difficult, because it has no characteristic symptoms and many diseases can manifest as headache and high blood pressure. Herein, we report a rare case of paraganglioma of the abdomen with headache and initial normal blood pressure. Read More

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http://dx.doi.org/10.1097/MD.0000000000013268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392613PMC
November 2018
14 Reads

10 good reasons why adrenal vein sampling is the preferred method for referring primary aldosteronism patients for adrenalectomy.

J Hypertens 2019 Mar;37(3):603-611

Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Japan.

: Nowadays most patients diagnosed with surgically curable primary aldosteronism have small or micro aldosterone-producing adenoma or unilateral micronodular hyperplasia, which are undetectable with available imaging technologies. Therefore, a negative imaging test by no means excludes unilateral primary aldosteronism. Moreover, about 10% of the subjects above the age of 35 years have nonfunctioning adrenal tumors, regardless of being hypertensive or not, with a prevalence that raises with aging. Read More

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http://Insights.ovid.com/crossref?an=00004872-900000000-9731
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http://dx.doi.org/10.1097/HJH.0000000000001939DOI Listing
March 2019
5 Reads

Renin dependent hypertension caused by accessory renal arteries.

Clin Hypertens 2018 1;24:15. Epub 2018 Nov 1.

Department of Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586 Kuching, Sarawak Malaysia.

Background: Hypokalemia in the presence of hypertension is often attributed to primary hyperaldosteronism as a cause of secondary hypertension, however secondary hyperaldosteronism may present similarly. Accessory renal arteries are variants in the vascular anatomy which are often thought to be innocuous but in some circumstances can cause renovascular hypertension leading to secondary hyperaldosteronism.

Case Presentation: We report 2 cases of hypertension with secondary hyperaldosteronism associated with accessory renal arteries. Read More

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https://clinicalhypertension.biomedcentral.com/articles/10.1
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http://dx.doi.org/10.1186/s40885-018-0100-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211501PMC
November 2018
19 Reads

Sustaining the momentum: Negative cross-sectional imaging for primary hyperaldosteronism should not preclude endocrine surgical referral.

Surgery 2019 Jan 19;165(1):219-220. Epub 2018 Oct 19.

Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.

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http://dx.doi.org/10.1016/j.surg.2018.08.032DOI Listing
January 2019
3 Reads

23-Sodium magnetic resonance imaging of the human heart revisited: new insights in patients with Conn's syndrome.

Eur Heart J Cardiovasc Imaging 2019 03;20(3):255-256

Department of Biomedical Imaging Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, UK.

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http://dx.doi.org/10.1093/ehjci/jey151DOI Listing
March 2019
1 Read

Increased myocardial sodium signal intensity in Conn's syndrome detected by 23Na magnetic resonance imaging.

Eur Heart J Cardiovasc Imaging 2019 03;20(3):263-270

Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.

Aims: Sodium intake has been linked to left ventricular hypertrophy independently of blood pressure, but the underlying mechanisms remain unclear. Primary hyperaldosteronism (PHA), a condition characterized by tissue sodium overload due to aldosterone excess, causes accelerated left ventricular hypertrophy compared to blood pressure matched patients with essential hypertension. We therefore hypothesized that the myocardium constitutes a novel site capable of sodium storage explaining the missing link between sodium and left ventricular hypertrophy. Read More

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http://dx.doi.org/10.1093/ehjci/jey134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383057PMC
March 2019
12 Reads

Improved identification of secondary hypertension: use of a systematic protocol.

Ann Transl Med 2018 Aug;6(15):293

Tulane University School of Medicine, Tulane Heart and Vascular Institute, New Orleans, Louisiana, USA.

Background: The accurate identification and diagnosis of secondary hypertension is critical, especially while atherosclerotic cardiovascular heart disease continues to be the leading cause of death in the industrialized world. Nevertheless, despite the existence of diagnostic tools, there are significant variations of the estimated prevalence of secondary hypertension, due to multiple etiologies and suboptimal recognition. This study demonstrates the results of using a systematic and protocolled approach to improve recognition of the presence of secondary hypertension. Read More

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http://atm.amegroups.com/article/view/20388/20342
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http://dx.doi.org/10.21037/atm.2018.06.25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123210PMC
August 2018
23 Reads

Characterization of fluorescence patterns exhibited by different adrenal tumors: Determining the indications for indocyanine green use in adrenalectomy.

Surgery 2018 11 4;164(5):972-977. Epub 2018 Aug 4.

Department of Endocrine Surgery, Cleveland Clinic, OH. Electronic address:

Background: A number of small studies have reported the use of indocyanine green imaging during adrenalectomy. Nevertheless, imaging properties of different tumors and the indications for indocyanine green imaging use in adrenalectomy have not been defined.

Methods: This is an Institutional Review Board-approved retrospective review of a prospectively maintained database. Read More

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http://dx.doi.org/10.1016/j.surg.2018.06.012DOI Listing
November 2018
11 Reads

Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism.

Hypertension 2018 09;72(3):641-649

From the Department of Endocrinology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., C.A., F.B., D.A.H., M.R.).

Unilateral primary aldosteronism is the most common surgically correctable form of endocrine hypertension and is usually differentiated from bilateral forms by adrenal venous sampling (AVS) or computed tomography (CT). Our objective was to compare clinical and biochemical postsurgical outcomes of patients with unilateral primary aldosteronism diagnosed by CT or AVS and identify predictors of surgical outcomes. Patient data were obtained from 18 internationally distributed centers and retrospectively analyzed for clinical and biochemical outcomes of adrenalectomy of patients with surgical management based on CT (n=235 patients, diagnosed from 1994-2016) or AVS (526 patients, diagnosed from 1994-2015) using the standardized PASO (Primary Aldosteronism Surgical Outcome) criteria. Read More

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http://dx.doi.org/10.1161/HYPERTENSIONAHA.118.11382DOI Listing
September 2018
12 Reads

Systolic heart failure in a patient with primary aldosteronism.

BMJ Case Rep 2018 Jun 8;2018. Epub 2018 Jun 8.

Endocrinology, St. Francis Medical Center, Trenton, New Jersey, USA.

A 53-year-old African man with a 25-year history of uncontrolled hypertension and systolic heart failure presented with an acute congestive heart failure exacerbation. He was found to have severe hypokalaemia, so additional testing was performed, and primary aldosteronism was confirmed. CT scan showed a 1. Read More

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http://dx.doi.org/10.1136/bcr-2018-225145DOI Listing
June 2018
4 Reads

Gitelman syndrome and primary hyperparathyroidism: a rare association.

BMJ Case Rep 2018 Jun 5;2018. Epub 2018 Jun 5.

Department of Endocrinology, Hospital Curry Cabral, Lisboa, Portugal.

Gitelman syndrome(GS) is a rare autosomal recessive salt-losing tubulopathy of young adults, characterised by hypokalaemia, hypomagnesaemia, hypocalciuria and secondary hyperaldosteronism. Hypercalcaemia due to hypocalciuria in these patients is extremely rare.A 25-year-old healthy woman was referred to the Endocrinology clinic for evaluation of persistent hypokalaemia. Read More

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http://dx.doi.org/10.1136/bcr-2017-223663DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990061PMC
June 2018
5 Reads

Adrenal androgen measurement for assessing the selectivity of adrenal venous sampling in primary aldosteronism.

Steroids 2018 06 11;134:16-21. Epub 2018 Apr 11.

Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, PR China. Electronic address:

Adrenal venous sampling (AVS) is the reference standard for primary aldosteronism (PA) subtyping. Cortisol is widely used to assess the success of selective AVS, but it is not always reliable. The aim of the present study was to investigate the usefulness of adrenal androgens, compared to cortisol, in assessing the selectivity of AVS. Read More

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http://dx.doi.org/10.1016/j.steroids.2018.04.002DOI Listing
June 2018
7 Reads

Two cases of hypokalaemic rhabdomyolysis: same but different.

BMJ Case Rep 2018 Mar 22;2018. Epub 2018 Mar 22.

Fourth Department of Medicine, Klinikum Wels-Grieskirchen, Wels, Austria.

In this paper, we present two women with hypokalaemic rhabdomyolysis in the context of increased diuretic intake and gastroenteritis, respectively. While their clinical manifestations and laboratory results were strikingly similar, two different underlying disorders were subsequently unveiled. The first patient was diagnosed with Conn syndrome, and adrenalectomy led to significant improvement of hypertension and sustained normokalaemia. Read More

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http://dx.doi.org/10.1136/bcr-2017-223609DOI Listing
March 2018
2 Reads

Downregulated Serum 14, 15-Epoxyeicosatrienoic Acid Is Associated With Abdominal Aortic Calcification in Patients With Primary Aldosteronism.

Hypertension 2018 04 12;71(4):592-598. Epub 2018 Feb 12.

From the Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Cardiology (P.L., J.G., W.H., H.H.), RNA Biomedical Institute (P.L., J.G., W.H., H.H.), Department of Endocrinology (S.Z., Y.L., L.Y.), and Department of Radiology (G.S.), Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; and British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.M.T.).

Patients with primary aldosteronism (PA) have increased risk of target-organ damage, among which vascular calcification is an important indicator of cardiovascular mortality. 14, 15-Epoxyeicosatrienoic acid (14, 15-EET) has been shown to have beneficial effects in vascular remodeling. However, whether 14, 15-EET associates with vascular calcification in PA is unknown. Read More

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http://dx.doi.org/10.1161/HYPERTENSIONAHA.117.10644DOI Listing
April 2018
8 Reads

Evaluation of quantitative parameters for distinguishing pheochromocytoma from other adrenal tumors.

Hypertens Res 2018 Mar 18;41(3):165-175. Epub 2018 Jan 18.

Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Adrenal tumors are increasingly found incidentally during imaging examinations. It is important to distinguish pheochromocytomas from other adrenal tumors because of the risk of hypertensive crisis. Although catecholamines and their metabolites are generally used to diagnose pheochromocytoma, false-positive test results are common. Read More

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http://www.nature.com/articles/s41440-017-0002-4
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http://dx.doi.org/10.1038/s41440-017-0002-4DOI Listing
March 2018
10 Reads

Image quality and radiation dose of low-tube-voltage CT with reduced contrast media for right adrenal vein imaging.

Eur J Radiol 2018 Jan 26;98:150-157. Epub 2017 Nov 26.

Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.

Objectives: To compare image quality and radiation dose of right adrenal vein (RAV) imaging computed tomography (CT) among conventional, low kV, and low kV with reduced contrast medium protocols.

Methods: One-hundred-and-twenty patients undergoing adrenal CT were randomly assigned to one of three protocols: contrast dose of 600mgI/kg at 120-kV tube voltage setting (600-120 group), 600mgI/kg at 80kV (600-80 group), and 360mgI/kg at 80kV (360-80 group). Iterative reconstruction was used for 80-kV groups. Read More

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http://dx.doi.org/10.1016/j.ejrad.2017.11.017DOI Listing
January 2018
12 Reads

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

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http://dx.doi.org/10.1136/bcr-2017-221530DOI Listing
December 2017
13 Reads

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).

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https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.117.09294DOI Listing
January 2018
9 Reads

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.).

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http://dx.doi.org/10.1161/HYPERTENSIONAHA.117.09295DOI Listing
January 2018
8 Reads

Subtyping of Patients with Primary Aldosteronism: An Update.

Horm Metab Res 2017 Dec 4;49(12):922-928. Epub 2017 Dec 4.

Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.

Primary aldosteronism (PA) comprises two main subtypes: unilateral aldosteronism, mainly caused by aldosterone-producing adenoma; and bilateral adrenal hyperplasia. Establishing the correct subtype in patients with PA is indispensible for choice of treatment. In addition to established methods, alternative tests are evolving for subtyping. Read More

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http://dx.doi.org/10.1055/s-0043-122602DOI Listing
December 2017
8 Reads

The Latest Developments of Functional Molecular Imaging in the Diagnosis of Primary Aldosteronism.

Horm Metab Res 2017 Dec 23;49(12):929-935. Epub 2017 Nov 23.

Clinical Research Institute of Endocrinology and Metabolic Diseases, Kyoto Medical Center, National Hospital Organization, Kyoto, Japan.

Differentiation of unilateral from bilateral aldosterone hypersecretion is the essential step in the clinical practice of primary aldosteronism (PA). Although adrenal venous sampling (AVS) has been established as the most standard test recommended by the guideline, its invasive and technically difficult nature has facilitated the approach to develop non-invasive functioning imaging as an alternative test. Compared to the conventional adrenocortical scintigraphy with cholesterol derivatives as tracer, the first-generation imaging, both of C-MTO/PET and I-IMTO/SPECT/CT, the second-generation imaging, bind with high specificity and affinity to CYP11B enzymes and have advantages in shortening the time for obtaining specific images, reducing the radiation exposure to the patient, and resolution of the images. Read More

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http://dx.doi.org/10.1055/s-0043-120672DOI Listing
December 2017
7 Reads

The SPARTACUS Trial: Controversies and Unresolved Issues.

Horm Metab Res 2017 Dec 17;49(12):936-942. Epub 2017 Nov 17.

Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia.

Adrenal vein sampling (AVS) is considered the gold standard for the differential diagnosis in patients with primary aldosteronism (PA). The distinction between unilateral and bilateral disease dictates the targeted therapeutic approach with surgery for aldosterone producing adenomas and medical therapy for patients with bilateral hyperplasia. Thereby, this diagnostic step is crucial in clinical care. Read More

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http://dx.doi.org/10.1055/s-0043-120524DOI Listing
December 2017
4 Reads

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

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https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.
Publisher Site
http://dx.doi.org/10.1161/HYPERTENSIONAHA.117.10197DOI Listing
January 2018
15 Reads

[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

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2017.42.011DOI Listing
November 2017
10 Reads

[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

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2017.42.004DOI Listing
November 2017
8 Reads

Visualization of right adrenal vein: Comparison with three phase dynamic contrast-enhanced CT.

Eur J Radiol 2017 Nov 24;96:104-108. Epub 2017 Aug 24.

Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.

Purpose: To evaluate the visualization of the right adrenal vein (RAV) on dynamic contrast-enhanced computed tomography (CT) images in patients with primary aldosteronism.

Materials And Methods: We evaluated 27 consecutive patients with primary aldosteronism who underwent contrast-enhanced dynamic CT and subsequent adrenal venous sampling. Scan delays were 10-, 20- and 60-s after a bolus-tracking program detected that the threshold of a 100 Hounsfield units (HU) increase in the abdominal aorta had been achieved. Read More

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http://dx.doi.org/10.1016/j.ejrad.2017.08.020DOI Listing
November 2017
6 Reads

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

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July 2017
7 Reads

Significance of Computed Tomography and Serum Potassium in Predicting Subtype Diagnosis of Primary Aldosteronism.

J Clin Endocrinol Metab 2018 03;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

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http://dx.doi.org/10.1210/jc.2017-01774DOI Listing
March 2018
39 Reads

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

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http://dx.doi.org/10.1111/imj.13651DOI Listing
February 2018
2 Reads

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

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http://dx.doi.org/10.1210/en.2017-00651DOI Listing
January 2018
12 Reads

Manifestation of hyperaldosteronism related hypokalemia in a case of anorexia nervosa.

Kaohsiung J Med Sci 2017 10 29;33(10):533-534. Epub 2017 Jun 29.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.kjms.2017.06.004DOI Listing
October 2017
1 Read

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

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http://dx.doi.org/10.1007/s11255-017-1705-9DOI Listing
December 2017
20 Reads

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

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http://dx.doi.org/10.1136/jclinpath-2017-204423DOI Listing
November 2017
8 Reads

Management of primary aldosteronism in patients with adrenal hemorrhage following adrenal vein sampling: A brief review with illustrative cases.

J Clin Hypertens (Greenwich) 2017 Dec 9;19(12):1372-1376. Epub 2017 Sep 9.

Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.

The authors describe the clinical investigation of two cases of primary aldosteronism with adrenal hemorrhage (AH) following adrenal vein sampling. A literature review was conducted regarding the medical management of primary aldosteronism in patients with AH following adrenal vein sampling. Guidelines on the management of primary aldosteronism with AH following adrenal vein sampling are lacking. Read More

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http://dx.doi.org/10.1111/jch.13059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5722684PMC
December 2017
18 Reads

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

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601392PMC
September 2017
30 Reads

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

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http://dx.doi.org/10.1155/2017/3093290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564109PMC
August 2017
11 Reads

Update in diagnosis and management of primary aldosteronism.

Clin Chem Lab Med 2018 02;56(3):360-372

Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Primary aldosteronism (PA) is a group of disorders in which aldosterone is excessively produced. These disorders can lead to hypertension, hypokalemia, hypervolemia and metabolic alkalosis. The prevalence of PA ranges from 5% to 12% around the globe, and the most common causes are adrenal adenoma and adrenal hyperplasia. Read More

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http://dx.doi.org/10.1515/cclm-2017-0217DOI Listing
February 2018
36 Reads

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

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http://dx.doi.org/10.1530/EJE-17-0417DOI Listing
November 2017
14 Reads

Discordance between imaging and immunohistochemistry in unilateral primary aldosteronism.

Clin Endocrinol (Oxf) 2017 Dec 4;87(6):665-672. Epub 2017 Sep 4.

Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA.

Objective: Correct subtyping of primary aldosteronism (PA) is essential for good surgical outcomes. Adrenal vein sampling (AVS) and/or computed tomography (CT) are used for PA subclassification. Clinical and/or biochemical improvement after surgery, however, is not always achieved in patients with presumed unilateral PA. Read More

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http://dx.doi.org/10.1111/cen.13442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698145PMC
December 2017
20 Reads