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Primary hyperaldosteronism

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https://www.readbyqxmd.com/read/28727636/a-comparison-of-robotic-versus-laparoscopic-adrenalectomy-in-patients-with-primary-hyperaldosteronism
#1
Jennifer Colvin, Vikram Krishnamurthy, Judy Jin, Joyce Shin, Allan Siperstein, Eren Berber
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. MATERIALS AND METHODS: The records of 20 patients who underwent RA for PHA were compared with 16 patients who underwent LA between 2000 and 2014...
July 19, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28721341/effects-of-eplerenone-on-resistance-to-antihypertensive-medication-in-patients-with-primary-or-secondary-hyperaldosteronism
#2
J David Spence, Chrysi Bogiatzi, Mariya Kuk, George K Dresser, Daniel G Hackam
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...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28699986/diagnosis-and-management-of-primary-aldosteronism
#3
Leticia A P Vilela, Madson Q Almeida
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...
May 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28688648/nationwide-review-of-hormonally-active-adrenal-tumors-highlights-high-morbidity-in-pheochromocytoma
#4
Punam P Parikh, Gustavo A Rubio, Josefina C Farra, John I Lew
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. This study examines in-hospital outcomes after unilateral adrenalectomy for hormonally active tumors. METHODS: A retrospective review was performed using the Nationwide Inpatient Sample (2006-2011) to identify patients undergoing unilateral adrenalectomy for hormonally active or inactive tumors...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28662194/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
#5
Piotr Jędrusik, Bartosz Symonides, Ewa Wojciechowska, Adam Gryglas, Zbigniew Gaciong
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. Correlations between SU and 24-hour collections were assessed for potassium levels and potassium/creatinine ratios. We used the PAHO formula to estimate 24-hour urinary potassium excretion based on SU potassium level...
2017: PloS One
https://www.readbyqxmd.com/read/28652474/rapid-screening-of-primary-aldosteronism-by-a-novel-chemiluminescent-immunoassay
#6
Ryo Morimoto, Yoshikiyo Ono, Yuta Tezuka, Masataka Kudo, Sachiko Yamamoto, Toshiaki Arai, Celso E Gomez-Sanchez, Hironobu Sasano, Sadayoshi Ito, Fumitoshi Satoh
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...
June 26, 2017: Hypertension
https://www.readbyqxmd.com/read/28631535/high-resolution-magnetic-resonance-imaging-for-exposing-facial-nerve-zonal-vulnerability-to-microbleeds-a-rare-cause-of-facial-palsy
#7
Charlie Chia-Tsong Hsu, Dalveer Singh, Trevor William Watkins, Gigi Nga Chi Kwan, Sachintha Hapugoda
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). The patient was initially treated for presumptive Bell's palsy. Subsequent magnetic resonance imaging of the brain and internal auditory canal showed two microbleeds at the left cerebellopontine angle...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28592038/-the-application-of-captopril-challenge-test-in-the-diagnosis-of-primary-aldosteronism
#8
S Chen, Z P Zeng, A L Song, L Zhu, L Lu, A L Tong, C Shi, H Z Li
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±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed. Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA). All patients received CCT. 24 h urine sodium was measured in partial patients...
June 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28498785/laparoscopic-adrenalectomy-for-conn-s-syndrome-is-beneficial-to-patients-and-is-cost-effective-in-england
#9
Ioannis Christakis, John A Livesey, Gregory P Sadler, Radu Mihai
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...
May 12, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28494487/a-case-of-confirmed-primary-hyperaldosteronism-diagnosed-despite-normal-screening-investigations
#10
Richard Carroll, Alana Gould, Joe Feltham, Simon Harper
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.
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28468286/clinical-utility-of-the-adrenocorticotropin-stimulation-test-with-without-dexamethasone-suppression-for-definitive-and-subtype-diagnosis-of-primary-aldosteronism
#11
Kosuke Inoue, Masao Omura, Chiho Sugisawa, Yuya Tsurutani, Jun Saito, Tetsuo Nishikawa
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). We estimated the difference in plasma aldosterone concentration (PAC) responsiveness to ACTH stimulation with single (AST alone) and combined (AST under 1-mg DS) tests within the same patient...
April 30, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28458337/outcomes-analysis-of-surgical-and-medical-treatments-for-patients-with-primary-aldosteronism
#12
Kyeong Seon Park, Jung Hee Kim, Ye Seul Yang, A Ram Hong, Dong-Hwa Lee, Min Kyong Moon, Sung Hee Choi, Chan Soo Shin, Sang Wan Kim, Seong Yeon Kim
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. We identified 269 patients who were treated for PA (unilateral excess: 221 cases; bilateral excess: 48 cases) during 2000-2015 at the Seoul National University Hospital and two other tertiary centers...
April 29, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28447626/familial-hyperaldosteronism-type-iii
#13
REVIEW
S Monticone, M Tetti, J Burrello, F Buffolo, R De Giovanni, F Veglio, T A Williams, P Mulatero
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. FH-III is caused by germline mutations in KCNJ5, encoding the potassium channel Kir3.4 (also called GIRK4). These mutations alter the selectivity filter of the channel and lead to abnormal ion currents with loss of potassium selectivity, sodium influx and consequent increased intracellular calcium that causes excessive aldosterone biosynthesis...
April 27, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28388725/histopathological-classification-of-cross-sectional-image-negative-hyperaldosteronism
#14
Yuto Yamazaki, Yasuhiro Nakamura, Kei Omata, Kazue Ise, Yuta Tezuka, Yoshikiyo Ono, Ryo Morimoto, Yukinaga Nozawa, Celso E Gomez-Sanchez, Scott A Tomlins, William E Rainey, Sadayoshi Ito, Fumitoshi Satoh, Hironobu Sasano
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...
April 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28332877/pentraxin-3-as-a-new-cardiovascular-marker-in-adrenal-adenomas
#15
Muhammed Kizilgul, Selvihan Beysel, Ozgur Ozcelik, Seyfullah Kan, Mahmut Apaydin, Mustafa Caliskan, Bekir Ucan, Erkam Sencar, Seyda Ozdemir, Erman Cakal
OBJECTIVE: Pentraxin 3 (PTX3) is an acute-phase glycoprotein, which is increased in patients with cardiovascular disease (CVD) and considered as a predictor of CVD in the general population. Both functional and nonfunctional adrenal tumors are associated with a higher risk of cardiovascular events and mortality. We aimed to investigate plasma PTX3 levels in patients with functioning and nonfunctioning adrenal tumors and determine its relationship with cardiovascular risk factors. METHODS: Twenty-one patients with functional adrenal tumors (11 pheochromocytomas, 9 Cushing syndrome, and 1 primary hyperaldosteronism), 28 patients with nonfunctional adrenal incidentalomas, and 40 healthy controls were enrolled in the study...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28321294/renin-angiotensin-aldosterone-system-altered-in-resistant-hypertension-in-sub-saharan-african-diabetes-patients-without-evidence-of-primary-hyperaldosteronism
#16
Bertille Elodie Edinga-Melenge, Vicky J Ama Moor, Jobert Richie N Nansseu, Romance Nguetse Djoumessi, Michel K Mengnjo, Jean-Claude Katte, Jean Jacques N Noubiap, Eugene Sobngwi
BACKGROUND: The renin-angiotensin-aldosterone system may be altered in patients with resistant hypertension. This study aimed to evaluate the relation between renin-angiotensin-aldosterone system activity and resistant hypertension in Cameroonian diabetes patients with resistant hypertension. METHODS: We carried out a case-control study including 19 diabetes patients with resistant hypertension and 19 diabetes patients with controlled hypertension matched to cases according to age, sex and duration of hypertension since diagnosis...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28289910/acid-base-disturbances-in-nephrotic-syndrome-analysis-using-the-co2-hco3-method-traditional-boston-model-and-the-physicochemical-method-stewart-model
#17
Tomomichi Kasagi, Hirokazu Imai, Naoto Miura, Keisuke Suzuki, Masabumi Yoshino, Hironobu Nobata, Takuhito Nagai, Shogo Banno
BACKGROUND: The Stewart model for analyzing acid-base disturbances emphasizes serum albumin levels, which are ignored in the traditional Boston model. We compared data derived using the Stewart model to those using the Boston model in patients with nephrotic syndrome. METHODS: Twenty-nine patients with nephrotic syndrome and six patients without urinary protein or acid-base disturbances provided blood and urine samples for analysis that included routine biochemical and arterial blood gas tests, plasma renin activity, and aldosterone...
March 13, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28289181/hypokalemia-and-pendrin-induction-by-aldosterone
#18
Ning Xu, Daigoro Hirohama, Kenichi Ishizawa, Wen Xiu Chang, Tatsuo Shimosawa, Toshiro Fujita, Shunya Uchida, Shigeru Shibata
Aldosterone plays an important role in regulating Na-Cl reabsorption and blood pressure. Epithelial Na(+) channel, Na(+)-Cl(-) cotransporter, and Cl(-)/HCO3(-) exchanger pendrin are the major mediators of Na-Cl transport in the aldosterone-sensitive distal nephron. Existing evidence also suggests that plasma K(+) concentration affects renal Na-Cl handling. In this study, we posited that hypokalemia modulates the effects of aldosterone on pendrin in hyperaldosteronism. Chronic aldosterone infusion in mice increased pendrin levels at the plasma membrane, and correcting hypokalemia in this model almost completely blocked pendrin upregulation...
May 2017: Hypertension
https://www.readbyqxmd.com/read/28259701/-long-term-blood-pressure-outcome-after-unilateral-adrenalectomy-for-primary-hyperaldosteronism
#19
F Saint, R Prader, C Cordonnier, G Choukroun, N Elesper, R Desailloud
OBJECTIVES: To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify prognostic factors associated. METHODS: Exhaustive retrospective review of all consecutive patients undergoing adrenalectomy for PA between 2002 and 2013 in our department. All patients underwent preoperative: clinical evaluation (age, sex, height, weight, systolic and diastolic BP under treatment, identification of anti-hypertension treatment), biological evaluation (potassium, renin, aldosterone) and radiological evaluation (CT and/or MRI)...
May 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28248752/radiofrequency-ablation-treatment-for-aldosterone-producing-adenomas
#20
Barry A Sacks, Ari C Sacks, Salomao Faintuch
PURPOSE OF REVIEW: To review the current status of radiofrequency ablation as a primary treatment for hyperfunctioning adrenal nodules, predominantly aldosterone-producing adenomas (APAs). RECENT FINDINGS: Radiofrequency ablation is an established treatment for focal benign and malignant lesions, including metastatic disease to the adrenal gland. Hyperaldosteronism is the leading cause of secondary hypertension with up to 80% due to APA, statistically the most common functioning adrenal nodule...
June 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
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