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diagnosis of primary aldosteronism

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https://www.readbyqxmd.com/read/28934817/aldosterone-to-renin-ratio-as-a-screening-instrument-for-primary-aldosteronism-in-a-middle-aged-population-with-atrial-fibrillation
#1
Georgios Mourtzinis, Ahmad Ebrahimi, Helena Gustafsson, Gudmundur Johannsson, Karin Manhem
Atrial fibrillation seems to be overrepresented among patients with primary aldosteronism. The aim of this study was to determine the usefulness of aldosterone to renin ratio as a screening instrument for primary aldosteronism in an atrial fibrillation population with relatively low cardiovascular risk profile. A total of 149 patients <65 years and with history of AF were screened for primary aldosteronism using aldosterone to renin ratio. Pathologically increased aldosterone to renin ratio (>65 pmol/mIU) was found in 15 participants (10...
September 21, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28904009/diagnosis-of-endocrine-disease-18-oxocortisol-and-18-hydroxycortisol-is-there-clinical-utility-of-these-steroids
#2
Jacques Lenders, Tracy A Williams, Martin Reincke, Celso E Gomez-Sanchez
Since the early nineteen eighties 18-hydroxycortisol and 18-oxocortisol have attracted attention when it was shown that the urinary excretion of these hybrid steroids was increased in primary aldosteronism. The development and more widespread use of specific assays has improved the understanding of their role in the (patho)physiology of adrenal disorders. The adrenal site of synthesis is not fully understood although it is clear that for the synthesis of 18-hydroxycortisol and 18-oxocortisol the action of both aldosterone synthase (zona glomerulosa) and 17α-hydroxylase (zona fasciculata) is required with cortisol as main substrate...
September 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28878203/biventricular-cardiac-hypertrophy-in-a-patient-with-primary-aldosteronism-and-atrial-septal-defect
#3
Tjokorda Gde Dalem Pemayun, Ridho M Naibaho, Muhammad Achmad Sungkar
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. She had previously been diagnosed having a right adrenal tumor and ostium secundum type ASD...
September 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28877721/a-case-of-adrenocoricotrophic-hormone-independent-bilateral-adrenocortical-macronodular-hyperplasia-concomitant-with-primary-aldosteronism
#4
Mao Tokumoto, Naoyoshi Onoda, Yukie Tauchi, Shinichiro Kashiwagi, Satoru Noda, Norikazu Toi, Masahumi Kurajoh, Masahiko Ohsawa, Yuto Yamazaki, Hironobu Sasano, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: Adrenocoricotrophic hormone (ACTH) - independent bilateral adrenocortical macronodular hyperplasia (AIMAH) is a rare cause of Cushing's syndrome, and is characterized by bilateral adrenal hyperplasia. However, Primary aldosteronism (PA) is a relatively common adrenal disease. CASE PRESENTATION: A 56-year-old man who has been treated hypertension and diabetes mellitus was detected low plasma potassium level with an elevated level of plasma aldosterone concentration and bilateral adrenal swelling...
September 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28870047/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-gitelman-syndrome
#5
(no author information available yet)
Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. The prevalence of GS is even higher in Asia than other countries. The majority of GS patients present mild and nonspecific symptoms during adolescence or adulthood...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28844072/update-in-diagnosis-and-management-of-primary-aldosteronism
#6
REVIEW
Sofia M Dick, Marina Queiroz, Bárbara L Bernardi, Angélica Dall'Agnol, Letícia A Brondani, Sandra P Silveiro
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. The importance of PA recognition arises from the fact that it can have a remarkably adverse cardiovascular and renal impact, which can even result in death. The aldosterone-to-renin ratio (ARR) is the election test for screening PA, and one of the confirmatory tests, such as oral sodium loading (OSL) or saline infusion test (SIT), is in general necessary to confirm the diagnosis...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28836616/heart-failure-with-reduced-ejection-fraction
#7
REVIEW
Michelle W Bloom, Barry Greenberg, Tiny Jaarsma, James L Januzzi, Carolyn S P Lam, Aldo P Maggioni, Jean-Noël Trochu, Javed Butler
Heart failure is a global public health problem that affects more than 26 million people worldwide. The global burden of heart failure is growing and is expected to increase substantially with the ageing of the population. Heart failure with reduced ejection fraction accounts for approximately 50% of all cases of heart failure in the United States and is associated with substantial morbidity and reduced quality of life. Several diseases, such as myocardial infarction, certain infectious diseases and endocrine disorders, can initiate a primary pathophysiological process that can lead to reduced ventricular function and to heart failure...
August 24, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28801285/-clinical-analysis-of-939-patients-with-adrenal-lesions-detected-by-abdominal-computed-tomography
#8
Cun-Xia Fan, Jia-Jun Zhang, Ying-Ying Cai, Chun-Yan Wu, Shao-Zhou Zou, Yi-Kai Xu, Yao-Ming Xue, Mei-Ping Guan
OBJECTIVE: To investigate the prevalence, etiology and clinical characteristics of adrenal lesions detected by abdominal computed tomography (CT). METHODS: This retrospective study was conducted in patients with adrenal lesions detected by abdominal CT examinations in Nanfang Hospital between July, 2014 and June, 2015. The clinical data of the patients were collected for analysis of the demographics, comorbidities, imaging characteristics, biochemical profiles, clinical diagnosis and intervention...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28780627/primary-pediatric-hypertension-current-understanding-and-emerging-concepts
#9
REVIEW
Andrew C Tiu, Michael D Bishop, Laureano D Asico, Pedro A Jose, Van Anthony M Villar
The rising prevalence of primary pediatric hypertension and its tracking into adult hypertension point to the importance of determining its pathogenesis to gain insights into its current and emerging management. Considering that the intricate control of BP is governed by a myriad of anatomical, molecular biological, biochemical, and physiological systems, multiple genes are likely to influence an individual's BP and susceptibility to develop hypertension. The long-term regulation of BP rests on renal and non-renal mechanisms...
September 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28762170/pheochromocytoma-with-synchronous-ipsilateral-adrenal-cortical-adenoma
#10
M Earth Hasassri, T K Pandian, Aleh A Bobr, Irina Bancos, William F Young, Melanie L Richards, David R Farley, Geoffrey B Thompson, Travis J McKenzie
BACKGROUND: Pheochromocytoma with synchronous ipsilateral adrenal cortical adenoma (PSCA) may present with mixed clinical, biochemical, and radiological features characteristic to each neoplasm subtype. METHODS: All patients with a pathological diagnosis of pheochromocytoma were evaluated for an ipsilateral cortical adenoma from 1994 through 2015. Retrospectively extracted data included indications for adrenalectomy, diagnostic workup (biochemical and radiographic), operative characteristics, pathological findings, and postoperative complications...
July 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28735660/case-detection-and-diagnosis-of-primary-aldosteronism-the-consensus-of-taiwan-society-of-aldosteronism
#11
Vin-Cent Wu, Ya-Hui Hu, Leay Kiaw Er, Ruoh-Fang Yen, Chia-Hui Chang, Ya-Li Chang, Ching-Chu Lu, Chin-Chen Chang, Jui-Hsiang Lin, Yen-Hung Lin, Tzung-Dau Wang, Chih-Yuan Wang, Shih Te Tu, Shih-Chieh Jeff Chueh, Ching-Chung Chang, Fen-Yu Tseng, Kwan-Dun Wu
BACKGROUND/PURPOSE: Even though the increasing clinical recognition of primary aldosteronism (PA) as a public health issue, its heightened risk profiles and the availability of targeted surgical/medical treatment being more understood, consensus in its diagnosis and management based on medical evidence, while recognizing the constraints of our real-world clinical practice in Taiwan, has not been reached. METHODS: The Taiwan Society of Aldosteronism (TSA) Task Force acknowledges the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics into the management of PA...
July 20, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28699986/diagnosis-and-management-of-primary-aldosteronism
#12
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/28661412/risk-of-new-onset-diabetes-mellitus-in-primary-aldosteronism-a-population-study-over-5-years
#13
Vin-Cent Wu, Shih-Chieh J Chueh, Likwang Chen, Chia-Hui Chang, Ya-Hui Hu, Yen-Hung Lin, Kwan-Dun Wu, Wei-Shiung Yang
OBJECTIVE: Abnormal glucose metabolism due to insulin resistance has been linked to aldosterone overproduction. However, the long-term incidence of new-onset diabetes mellitus (NODM) among patients with primary aldosteronism after targeted treatment has not been well documented. METHODS: The diagnosis of primary aldosteronism and essential hypertension were identified, and then the occurrence of NODM, all-cause mortality among these patients, was ascertained by a validated algorithm from a 23-million population insurance registry...
August 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28652474/rapid-screening-of-primary-aldosteronism-by-a-novel-chemiluminescent-immunoassay
#14
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...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28652464/rapid-diagnosis-of-primary-aldosteronism-oxymoron-or-one-small-step
#15
EDITORIAL
Morris J Brown
No abstract text is available yet for this article.
June 26, 2017: Hypertension
https://www.readbyqxmd.com/read/28592038/-the-application-of-captopril-challenge-test-in-the-diagnosis-of-primary-aldosteronism
#16
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/28584016/aldosterone-producing-adenomas-histopathology-genotype-correlation-and-identification-of-a-novel-cacna1d-mutation
#17
Geok Chin Tan, Giulia Negro, Alexandra Pinggera, Nur Maya Sabrina Tizen Laim, Isa Mohamed Rose, Jiri Ceral, Ales Ryska, Long Kha Chin, Nor Azmi Kamaruddin, Norfilza Mohd Mokhtar, A Rahman A Jamal, Norlela Sukor, Miroslav Solar, Joerg Striessnig, Morris Jonathan Brown, Elena Aisha Azizan
Mutations in KCNJ5, ATP1A1, ATP2B3, CACNA1D, and CTNNB1 are thought to cause the excessive autonomous aldosterone secretion of aldosterone-producing adenomas (APAs). The histopathology of KCNJ5 mutant APAs, the most common and largest, has been thoroughly investigated and shown to have a zona fasciculata-like composition. This study aims to characterize the histopathologic spectrum of the other genotypes and document the proliferation rate of the different sized APAs. Adrenals from 39 primary aldosteronism patients were immunohistochemically stained for CYP11B2 to confirm diagnosis of an APA...
July 2017: Hypertension
https://www.readbyqxmd.com/read/28556585/a-practical-approach-to-diagnosing-endocrine-hypertension
#18
REVIEW
Jun Yang, Jimmy Shen, Peter J Fuller
Hypertension is a leading cardiovascular risk factor that remains difficult to manage in a large segment of the population. Secondary causes of hypertension, which are amenable to targeted treatment or even cure, may contribute to poor blood pressure control. The most common endocrine cause, primary aldosteronism, requires biochemical screening as there are often no symptoms or signs other than hypertension. Screening tests should be done after adequate preparation to optimise the results and minimise the confounding effects of diet and medications...
May 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28545803/impact-of-a-multidisciplinary-heart-failure-postdischarge-management-clinic-on-medication-adherence
#19
Lingyun Lu, Cynthia A Jackevicius, Noelle K de Leon, Alberta L Warner, Donald S Chang, Freny Vaghaiwalla Mody
PURPOSE: Disease management programs have been associated with improved adherence to heart failure (HF) medications. However, there remain limited data on the benefit of a comprehensive multidisciplinary HF postdischarge management (PDM) clinic that promptly follows HF-related hospitalization on evidence-based HF medication adherence. OBJECTIVE: The aim of this study was to evaluate the effects of an HF-PDM clinic on adherence to evidence-based HF medication therapy...
May 22, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28540931/hyperkalemia-in-both-surgically-and-medically-treated-patients-with-primary-aldosteronism
#20
N Wada, Y Shibayama, H Umakoshi, T Ichijo, Y Fujii, K Kamemura, T Kai, R Sakamoto, A Ogo, Y Matsuda, T Fukuoka, M Tsuiki, T Suzuki, M Naruse
Hyperkalemia is an important complication of adrenalectomy for patients with primary aldosteronism (PA). The frequency of hyperkalemia after medication using mineralocorticoid receptor antagonists (MRAs) for PA is unclear. The aim of this study is to investigate the frequency and the risk factors of hyperkalemia after surgery and medication for PA. The data of 376 patients with PA registered in a multicentre-collaborative study in Japan, including surgically treated patients (group A; n=142) and medically treated patients with MRAs (group B; n=234) were studied...
October 2017: Journal of Human Hypertension
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