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Adrenal adenomas

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https://www.readbyqxmd.com/read/29218429/protein-expression-of-pttg1-as-a-diagnostic-biomarker-in-adrenocortical-carcinoma
#1
Minerva Angélica Romero Arenas, Timothy G Whitsett, Anna Aronova, Samuel A Henderson, Janine LoBello, Mouhammed Amir Habra, Elizabeth G Grubbs, Jeffrey E Lee, Kanishka Sircar, Rasa Zarnegar, Theresa Scognamiglio, Thomas J Fahey, Nancy D Perrier, Michael J Demeure
BACKGROUND: Adrenocortical carcinoma (ACC) has a poor prognosis and there is an unmet clinical need for biomarkers to improve both diagnostic and prognostic assessment. Pituitary-tumor transforming gene (PTTG1) has been shown to modulate cancer invasiveness and response to therapy. The potential role of PTTG1 protein levels in ACC has not been previously addressed. We assessed whether increased nuclear protein expression of PTTG1 distinguished ACCs from adrenocortical adenomas (ACAs)...
December 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29214448/the-role-of-dynamic-post-contrast-t1-w-mri-sequence-to-characterize-lipid-rich-and-lipid-poor-adrenal-adenomas-in-comparison-to-non-adenoma-lesions-preliminary-results
#2
Valeria Romeo, Simone Maurea, Salvatore Guarino, Pier Paolo Mainenti, Raffaele Liuzzi, Mario Petretta, Immacolata Cozzolino, Michele Klain, Arturo Brunetti
PURPOSE: The purpose of the article is to compare the features of wash-out (WO) parameters between lipid-rich and lipid-poor adrenal adenomas as well as with a group of non-adenoma adrenal lesions. METHODS: 46 patients (36 F and 10 M, median age 58 years) with unilateral adrenal lesions (35 adenomas, 7 pheochromocytomas, 1 carcinoma, and 3 metastases) were prospectively evaluated; adrenal lesions were divided into adenomas (Group 1) and non-adenomas (Group 2)...
December 6, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29214084/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
#3
S S C Gunatilake, U Bulugahapitiya
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. Autoimmune hyperthyroidism (Graves' disease) and primary hyperaldosteronism rarely coexist but underlying mechanisms associating the two are still unclear...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29202495/disordered-cyp11b2-expression-in-primary-aldosteronism
#4
Celso E Gomez-Sanchez, Maniselvan Kuppusamy, Martin Reincke, Tracy Ann Williams
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...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29202494/aldosterone-producing-cell-clusters-in-normal-and-pathological-states
#5
Kei Omata, Scott A Tomlins, William E Rainey
Primary aldosteronism (PA) significantly increases the risk of cardiovascular complications, and early diagnosis and targeted treatment based on its pathophysiology is warranted. Next-generation sequencing (NGS) has revealed recurrent somatic mutations in aldosterone-driving genes in aldosterone-producing adenoma (APA). By applying CYP11B2 (aldosterone synthase) immunohistochemistry and NGS to adrenal glands from normal subjects and PA patients, we and others have shown that CYP11B2-positive cells make small clusters, termed aldosterone-producing cell clusters (APCC), beneath the adrenal capsule, and that APCC harbor somatic mutations in genes mutated in APA...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29202493/health-related-quality-of-life-and-mental-health-in-primary-aldosteronism-a-systematic-review
#6
Marieke S Velema, Aline H de Nooijer, Vivian W G Burgers, Ad R M M Hermus, Henri J L M Timmers, Jacques W M Lenders, Olga Husson, Jaap Deinum
The aim of this review was to determine the impact of primary aldosteronism on health-related quality of life (HRQoL) and mental health. We performed a systematic literature search up to July 2017 in six electronic databases. First, we screened the articles derived from this search based on title and abstract. Second, the selected studies were systematically reviewed and checked for our predefined inclusion criteria. The search yielded 753 articles, of which 15 studies met our inclusion criteria. Untreated patients with primary aldosteronism showed an impaired physical and mental HRQoL as compared to the general population...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29202492/subtyping-of-patients-with-primary-aldosteronism-an-update
#7
Jacques W M Lenders, Graeme Eisenhofer, Martin Reincke
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. Computed tomography (CT) and adrenal venous sampling (AVS) are currently recommended in the guidelines for the diagnostic work-up of patients with PA. CT cannot be used as a stand-alone test for subtyping because of its limited accuracy but may be used in combination with other tests such as AVS or functional imaging...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29198769/subtyping-of-primary-aldosteronism-with-adrenal-vein-sampling-hormone-and-side-specific-effects-of-cosyntropin-and-metoclopramide
#8
Giacomo Rossitto, Giuseppe Maiolino, Livia Lenzini, Valeria Bisogni, Teresa Maria Seccia, Maurizio Cesari, Maurizio Iacobone, Gian Paolo Rossi
BACKGROUND: Cosyntropin and metoclopramide can affect the subtyping of primary aldosteronism when used with adrenal vein sampling by exerting hormone- and side-specific effects on cortisol and aldosterone secretion. We investigated how these stimuli affect the selectivity index, the relative aldosterone secretion index, and the lateralization index in consecutive primary aldosteronism patients submitted to adrenal vein sampling. METHODS: We recruited 171 patients; of these, 149 underwent adrenal vein sampling before and after stimulation with cosyntropin (250 µg intravenous bolus, n= 53, 73% with an aldosterone-producing adenoma) or with metoclopramide (10 mg intravenous bolus, n= 96, 65% aldosterone-producing adenoma), and 32 with an aldosterone-producing adenoma were investigated for the relative gene expression of dopamine, melanocortin 2, and 5-hydroxytryptamine (serotonin) 4 receptor with microarrays...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29194699/ultrasonographic-findings-of-1385-adrenal-masses-a-retrospective-study-of-1319-benign-and-66-malignant-masses
#9
Xia Gong, Yifei Yu, Weiwei Zhan
OBJECTIVES: To evaluate the features of adrenal masses on ultrasonography and correlate the findings with the pathologic diagnoses to help distinguish benign from malignant adrenal lesions. METHODS: Ultrasonography was performed in 1363 patients with adrenal lesions. The following ultrasonographic parameters were recorded: size, shape, margin, echogenicity, echo texture, cystic necrosis, calcifications, and blood supply. The sensitivity and specificity of aggressive features for predicting malignancy were calculated...
December 1, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29190995/predictors-of-hypertension-urgency-in-primary-aldosteronism-patients-during-the-first-24-hours-after-surgery
#10
Juping Zhao, Jun Dai, Wenlong Zhou, Haofei Wang, Wenbin Rui, Wei He, Zhe Zhu, Yu Zhu, Danfeng Xu, Fukang Sun
Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed...
November 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29184271/a-case-of-cushing-s-syndrome-in-pregnancy
#11
Leila Pourali, Atiyeh Mohammadzade Vatanchi, Anahita Hamidi
Cushing's syndrome (CS) occurs rarely during pregnancy. CS can be caused by prolonged abnormal exposure to excess glucocorticoids leading to special and significant signs and symptoms. It is often difficult to diagnose pathological hypercortisolism in pregnant women since some symptoms of the disease might be due to a complicated pregnancy, including preeclampsia or gestational diabetes. In this study, we report the case of a 29-year-old female who referred to our institution with hypertension, weakness, steria, and truncal obesity...
November 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29183089/successful-treatment-of-estrogen-excess-in-primary-bilateral-macronodular-adrenocortical-hyperplasia-with-leuprolide-acetate
#12
Fady Hannah-Shmouni, Andreas G Moraitis, Vladimir Valera Romero, Fabio R Faucz, Spyridon A Mastroyannis, Annabel Berthon, Richard A Failor, Maria Merino, Andrew P Demidowich, Constantine A Stratakis
Primary bilateral macronodular adrenocortical hyperplasia (PBMAH) is an uncommon cause of adrenal Cushing syndrome (CS) in which cortisol and occasionally other steroid hormones can be secreted under the influence of aberrantly expressed G-protein coupled receptors (GPCRs) in the adrenal cortex. We describe the unique case of a 64-year-old postmenopausal female with PBMAH whose adrenal lesions expressed luteinizing hormone receptors (LHr). She presented initially with CS and underwent right adrenalectomy; a few years later she presented with macromastia and mastodynia, possibly due to estrogen excess from her remaining left adrenocortical masses...
November 28, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29182204/-long-qt-syndrome-and-polymorphic-ventricular-tachycardia-due-to-hypopituitarism-report-of-one-case
#13
José Miguel García-Castro, Antonia García-Martín, Emilio Guirao-Arrabal, Pedro Luis Carrillo-Alascio
Symptoms of hypopituitarism are usually chronic and nonspecific, but rarely the disease can have acute and life threatening manifestations. We report a 53 years old female with a pituitary adenoma that was admitted to our hospital because of syncope. The electrocardiogram showed sinus bradycardia with a prolonged QT interval. Frequent runs of non-sustained polymorphic ventricular tachycardia were noted on telemetry. The patient had a history of severe acute headaches in the previous days and laboratory tests revealed severe secondary hypothyroidism, adrenal insufficiency and a decrease in pituitary hormones...
July 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29176595/the-presence-of-nonfunctioning-adrenal-incidentalomas-increases-arterial-hypertension-frequency-and-severity-and-is-associated-with-cortisol-levels-after-dexamethasone-suppression-test
#14
Mariana Arruda, Emanuela Mello Ribeiro Cavalari, Marcela Pessoa de Paula, Felipe Fernandes Cordeiro de Morais, Guilherme Furtado Bilro, Maria Caroline Alves Coelho, Nathalie Anne de Oliveira E Silva de Morais, Diana Choeri, Aline Moraes, Leonardo Vieira Neto
There are limited data regarding the frequency of hypertension in nonfunctioning adrenal incidentaloma (NFAI). Our objectives were to investigate rates of hypertension and resistant hypertension in NFAI patients, and compare them to a control group without adrenal adenoma. We also aimed to evaluate the relationship between cortisol levels after 1 mg-dexamethasone suppression test (DST) and hypertension in NFAI patients. We selected 40 patients with NFAI and 40 control patients over the age of 18 without adrenal lesions on abdominal imaging...
November 24, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29169191/the-latest-developments-of-functional-molecular-imaging-in-the-diagnosis-of-primary-aldosteronism
#15
Mitsuhide Naruse, Hironobu Umakoshi, Mika Tsuiki, Maki Yokomoto, Tetsuya Tagami, Akiyo Tanabe, Akira Shimatsu
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 (11)C-MTO/PET and (123)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...
November 23, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29165736/the-spartacus-trial-controversies-and-unresolved-issues
#16
Felix Beuschlein, Paolo Mulatero, Evelyn Asbach, Silvia Monticone, Cristiana Catena, Leonardo A Sechi, Michael Stowasser
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. As AVS is an invasive, not well standardized procedure that is restricted to few specialized centers, several attempts have been made to simplify diagnostic algorithms...
November 17, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29165597/gsta1-expression-is-correlated-with-aldosterone-level-in-kcnj5-mutated-adrenal-aldosterone-producing-adenoma
#17
Xintao Li, Baojun Wang, Lu Tang, Yu Zhang, Luyao Chen, Liangyou Gu, Fan Zhang, Jinzhi Ouyang, Xu Zhang
Context: KCNJ5 mutation is a major cause of aldosterone-producing adenoma (APA). The development of APA apart from KCNJ5 mutation is less investigated. Objective: To investigate other mechanisms affecting aldosterone secretion apart from KCNJ5. Patients and Methods: Six pairs of KCNJ5-mutated, high and low aldosterone-secreting APAs, five non-KCNJ5-mutated APAs and four normal adrenal glands were assayed by Affymetrix Genechip Human Transcriptome Array 2...
November 20, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29164520/adrenal-myelolipoma-a-comprehensive-review
#18
REVIEW
Ábel Decmann, Pál Perge, Miklós Tóth, Peter Igaz
INTRODUCTION: Adrenal myelolipoma is an invariably benign neoplasm of the adrenal gland that is the second most common primary adrenal incidentaloma following adrenocortical adenomas. It is composed of elements of adipose tissue and extramedullary hematopoiesis. Hypotheses on stem cells and hormonal factors have been formulated regarding its pathogenesis that is still obscure. Despite its benign behavior, adrenal myelolipoma is clinically relevant as it might cause significant difficulties in the differential diagnosis of adrenal tumors...
November 21, 2017: Endocrine
https://www.readbyqxmd.com/read/29164516/mineralocorticoid-receptor-antagonism-protects-the-aorta-from-vascular-smooth-muscle-cell-proliferation-and-collagen-deposition-in-a-rat-model-of-adrenal-aldosterone-producing-adenoma
#19
Yongji Yan, Chao Wang, Yiqin Lu, Huijie Gong, Zhun Wu, Xin Ma, Hongzhao Li, Baojun Wang, Xu Zhang
The number of patients with adrenal aldosterone-producing adenomas (APAs) has gradually increased. However, even after adenoma resection, some patients still suffer from high systolic blood pressure (SBP), which is possibly due to great arterial remodeling. Moreover, mineralocorticoid receptors (MRs) were found to be expressed in vascular smooth muscle cells (VSMCs). This study aims to determine whether MR antagonism protects the aorta from aldosterone-induced aortic remolding. Male rats were subcutaneously implanted with an osmotic minipumps and randomly divided into four groups: control; aldosterone (1 μg/h); aldosterone plus a specific MR antagonist, eplerenone (100 mg/kg/day); and aldosterone plus a vasodilator, hydralazine (25 mg/kg/day)...
November 21, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/29157485/la-chirurgie-d%C3%A2-%C3%A3-pargne-surr%C3%A3-nalienne-du-cortex-%C3%A3-la-m%C3%A3-dulla-cortical-sparing-surgery-from-cortex-to-medulla
#20
A Ferriere, V Kerlan, A Tabarin
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%)...
October 2017: Annales D'endocrinologie
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