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Aldosterone producing adenoma

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https://www.readbyqxmd.com/read/28422753/steroid-metabolome-analysis-reveals-prevalent-glucocorticoid-excess-in-primary-aldosteronism
#1
Wiebke Arlt, Katharina Lang, Alice J Sitch, Anna S Dietz, Yara Rhayem, Irina Bancos, Annette Feuchtinger, Vasileios Chortis, Lorna C Gilligan, Philippe Ludwig, Anna Riester, Evelyn Asbach, Beverly A Hughes, Donna M O'Neil, Martin Bidlingmaier, Jeremy W Tomlinson, Zaki K Hassan-Smith, D Aled Rees, Christian Adolf, Stefanie Hahner, Marcus Quinkler, Tanja Dekkers, Jaap Deinum, Michael Biehl, Brian G Keevil, Cedric H L Shackleton, Jonathan J Deeks, Axel K Walch, Felix Beuschlein, Martin Reincke
BACKGROUND: Adrenal aldosterone excess is the most common cause of secondary hypertension and is associated with increased cardiovascular morbidity. However, adverse metabolic risk in primary aldosteronism extends beyond hypertension, with increased rates of insulin resistance, type 2 diabetes, and osteoporosis, which cannot be easily explained by aldosterone excess. METHODS: We performed mass spectrometry-based analysis of a 24-hour urine steroid metabolome in 174 newly diagnosed patients with primary aldosteronism (103 unilateral adenomas, 71 bilateral adrenal hyperplasias) in comparison to 162 healthy controls, 56 patients with endocrine inactive adrenal adenoma, 104 patients with mild subclinical, and 47 with clinically overt adrenal cortisol excess...
April 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28420172/subtype-diagnosis-of-primary-aldosteronism-is-adrenal-vein-sampling-always-necessary
#2
REVIEW
Fabrizio Buffolo, Silvia Monticone, Tracy A Williams, Denis Rossato, Jacopo Burrello, Martina Tetti, Franco Veglio, Paolo Mulatero
Aldosterone producing adenoma and bilateral adrenal hyperplasia are the two most common subtypes of primary aldosteronism (PA) that require targeted and distinct therapeutic approaches: unilateral adrenalectomy or lifelong medical therapy with mineralocorticoid receptor antagonists. According to the 2016 Endocrine Society Guideline, adrenal venous sampling (AVS) is the gold standard test to distinguish between unilateral and bilateral aldosterone overproduction and therefore, to safely refer patients with PA to surgery...
April 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28416583/physiological-and-pathological-roles-in-human-adrenal-of-the-glomeruli-defining-matrix-protein-npnt-nephronectin
#3
Ada Ee Der Teo, Sumedha Garg, Timothy Isaac Johnson, Wanfeng Zhao, Junhua Zhou, Celso Enrique Gomez-Sanchez, Mark Gurnell, Morris Jonathan Brown
Primary aldosteronism is a common cause of hypertension, which becomes refractory if undiagnosed, but potentially curable when caused by an aldosterone-producing adenoma (APA). The discovery of somatic mutations and differences in clinical presentations led to recognition of small but common zona glomerulosa (ZG)-like adenomas, distinct from classical large zona fasciculata-like adenomas. The inverse correlation between APA size and aldosterone synthase expression prompted us to undertake a systematic study of genotype-phenotype relationships...
April 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28415786/arterial-stiffness-and-blood-pressure-improvement-in-aldosterone-producing-adenoma-harboring-kcnj5-mutations-after-adrenalectomy
#4
Chia-Hui Chang, Ya-Hui Hu, Yao-Chou Tsai, Che-Hsiung Wu, Shuo-Meng Wang, Lian-Yu Lin, Yen-Hung Lin, Fumitoshi Satoh, Kwan-Dun Wu, Vin-Cent Wu
The aim of this study was to show the effect of KCNJ5 mutational status on arterial stiffness in aldosterone-producing adenomas after adrenalectomy. Between February 2008 and January 2010, we prospectively enrolled 108 aldosterone-producing adenoma patients undergoing adrenalectomy. We conducted repeated measurements of pulse wave velocity at baseline, 6 months, and 12 months after adrenalectomy, grouped by KCNJ5 mutational status. Prognostic factors of arterial stiffness and risk for hypertension at 12 months after adrenalectomy were analyzed after propensity score matching in a 1:1 ratio...
March 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28405879/histopathological-and-genetic-characterization-of-aldosterone-producing-adenomas-with-concurrent-subclinical-cortisol-hypersecretion-a-case-series
#5
Francesco Fallo, Isabella Castellano, Celso E Gomez-Sanchez, Yara Rhayem, Catia Pilon, Valentina Vicennati, Donatella Santini, Valeria Maffeis, Ambrogio Fassina, Paolo Mulatero, Felix Beuschlein, Martin Reincke
PURPOSE: Aldosterone-producing adenomas with concurrent subclinical cortisol hypersecretion are reported in an increasing number of patients. Five aldosterone-producing adenomas from patients with primary aldosteronism and subclinical hypercortisolism were examined. THE AIMS OF OUR STUDY WERE: (1) to analyze pathological features and immunohistochemical expression of CYP11B1 (11β-hydroxylase) and CYP11B2 (aldosterone synthase) in these tumors; (2) to investigate somatic mutations involved in adrenal steroid hypersecretion and/or tumor growth...
April 12, 2017: Endocrine
https://www.readbyqxmd.com/read/28400483/somatic-and-inherited-mutations-in-primary-aldosteronism
#6
Fabio Luiz Fernandes-Rosa, Sheerazed Boulkroun, Maria-Christina Zennaro
Primary aldosteronism (PA), the most common form of secondary hypertension, is caused in the majority of cases by unilateral aldosterone producing adenoma (APA) or bilateral adrenal hyperplasia. In the last years, recurrent somatic mutations in KCNJ5, CACNA1D, ATP1A1, and ATP2B3 were proved to be associated with APA development, explaining more than 50% of sporadic APA. The identification of these mutations have allowed the establishment of a model for APA development involving modifications in the intracellular ionic equilibrium and in the regulation of cell membrane potential, leading to autonomous aldosterone overproduction...
April 11, 2017: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/28385310/prevalence-and-clinical-manifestations-of-primary-aldosteronism-encountered-in-primary%C3%A2-care%C3%A2-practice
#7
Silvia Monticone, Jacopo Burrello, Davide Tizzani, Chiara Bertello, Andrea Viola, Fabrizio Buffolo, Luisa Gabetti, Giulio Mengozzi, Tracy A Williams, Franco Rabbia, Franco Veglio, Paolo Mulatero
BACKGROUND: Despite being widely recognized as the most common form of secondary hypertension, among the general hypertensive population the true prevalence of primary aldosteronism (PA) and its main subtypes, aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH), remains a matter of debate. OBJECTIVES: This study sought to determine the prevalence and clinical phenotype of PA in a large cohort of unselected patients with hypertension, consecutively referred to our hypertension unit, by 19 general practitioners from Torino, Italy...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28378050/adrenal-vein-sampling-for-primary-aldosteronism-a-2-week-protocol-for-withdrawal-of-renin-stimulating-antihypertensives
#8
Kevin C Ching, Debbie L Cohen, Douglas L Fraker, Scott O Trerotola
OBJECTIVE: For evaluation of primary aldosteronism, international guidelines recommend a 4-6 week withdrawal of spironolactone, eplerenone, and amiloride prior to adrenal vein sampling (AVS). It is not always feasible to withdraw these drugs in patients with severe hypertension and hypokalemia. We present our experience evaluating the efficacy and clinical outcomes of a 2-week protocol for withdrawal of renin-stimulating antihypertensives prior to AVS. DESIGN: A single-center retrospective review of all patients who underwent AVS for primary aldosteronism between January 2014 and December 2015...
April 4, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28368480/genetic-and-histopathologic-inter-tumor-heterogeneity-in-primary-aldosteronism
#9
Kei Omata, Yuto Yamazaki, Yasuhiro Nakamura, Sharath K Anand, Justine A Barletta, Hironobu Sasano, William E Rainey, Scott A Tomlins, Anand Vaidya
Context: Whether primary aldosteronism (PA) is the consequence of a monoclonal or multiclonal process is unclear. Case Description: A 48-year-old man with severe bilateral PA refractory to medical therapy underwent unilateral adrenalectomy of the dominant adrenal. Although computed tomography (CT) showed three left-sided cortical nodules, post-surgical histopathology and genetic analysis revealed five different adrenocortical adenomas. Two zona fasciculata (ZF)-like aldosterone producing adenomas (APAs) each harbored distinct known somatic KCNJ5 mutations (L168R and T158A)...
March 24, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28332723/evidence-for-persistent-organochlorine-pollutants-in-the-human-adrenal-cortex
#10
Enza Fommei, Roberta Turci, Andrea Ripoli, Silvana Balzan, Fabrizio Bianchi, Luca Morelli, Alessio Coi
Environmental pollutants may act as endocrine disruptors in animals. Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) enter the food chain and may accumulate in the fatty animal tissues, including adrenals. To our knowledge, no previous study has investigated their presence in the human normal adrenal (NA) cortex and aldosterone-producing adenomas (APA). Surgical fragments of APA from 11 patients and NA from 8 kidney donors were analyzed for 16 PCBs congeners and 10 OCPs. A Matrix Solid-Phase Dispersion (MSPD) method for simultaneous determination of the target compounds in cortex homogenates was developed...
March 23, 2017: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/28293914/a-late-diagnosis-of-primary-aldosteronism
#11
Francesco Zorzi, Oliviero Olivieri, Paolo Brazzarola, Francesca Pizzolo
We report the case of a 41-year-old male patient with juvenile onset refractory hypertension while taking four drugs including a diuretic. Fourteen years before he underwent a complete investigation for secondary hypertension (including the aldosterone to renin ratio-ARR) that was negative. Since that, hypertension control gradually worsened, hypertensive organ damage aggravated and hypokalemia developed in spite of ACE inhibitor treatment. At the re-evaluation ARR was elevated, and the further workup for primary aldosteronism demonstrated an unilateral aldosterone producing adenoma that was surgically removed, with subsequent optimal blood pressure control with two anti-hypertensive drugs...
March 14, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28276424/-11-c-metomidate-pet-ct-scanning-can-identify-aldosterone-producing-adenomas-after-unsuccessful-lateralisation-with-ct-mri-and-adrenal-venous-sampling
#12
J Ouyang, R Hardy, M Brown, T Helliwell, M Gurnell, D J Cuthbertson
No abstract text is available yet for this article.
March 9, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28248752/radiofrequency-ablation-treatment-for-aldosterone-producing-adenomas
#13
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...
February 28, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28222463/changes-in-body-mass-index-in-pheochromocytoma-patients-following-adrenalectomy
#14
Ariadni Spyroglou, Christian Adolf, Stefanie Hahner, Marcus Quinkler, Roland Ladurner, Martin Reincke, Felix Beuschlein
Catecholamine excess from pheochromocytoma results in cardiovascular symptoms such as arterial hypertension and tachycardia and induces metabolic alterations including glucose intolerance and increase in resting metabolic rate. The objective of our study was to investigate the effect of surgical cure of pheochromocytoma on body-mass-index and the correlation of body-mass-index changes to preoperative endocrine parameters. Pheochromocytoma patients from the Munich ENSAT Registry were matched (1:2) for age and gender to patients from the German Conn's Registry, who had undergone surgery for aldosterone-producing-adenomas...
March 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28111697/assessment-of-the-aldosteronona-resolution-score-as-a-predictive-resolution-score-of-hypertension-after-adrenalectomy-for-aldosteronoma-in-french-patients
#15
Ludwig Pasquier, Medhi Kirouani, Florian Fanget, Claire Nomine, Cécile Caillard, Vincent Arnault, Jean-Baptiste Finel, Niki Christou, Muriel Mathonnet, Christophe Trésallet, Antoine Hamy, Loïc de Calan, Laurent Brunaud, Fabrice Menegaux, Jean Christophe Lifante, Jean Benoit Hardouin, Delphine Drui, Éric Mirallié, Claire Blanchard
PURPOSE: Aldosteronoma Resolution Score (ARS) is a predictive score for cure of hypertension after adrenalectomy for hyperaldosteronism and has been validated in American patients. The aim of the study was to validate this score in a French population. METHOD: Data concerning patients operated from 2002 to 2015 in 7 French University Hospitals were retrospectively collected. Diagnosis of Aldosterone-producing adenoma (APA) was confirmed with clinical and biochemical hyperaldosteronism and adrenal nodule on CT scan...
March 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28111382/aldosterone-excess-may-inhibit-insulin-secretion-a-comparative-study-on-glucose-metabolism-pre-and-post-adrenalectomy-in-patients-with-primary-aldosteronism
#16
Yuya Tsurutani, Chiho Sugisawa, Akiko Ishida, Kosuke Inoue, Jun Saito, Masao Omura, Shoichiro Nagasaka, Tetsuo Nishikawa
Conflicting data have been published on the effects of aldosterone excess on glucose metabolism. Specifically, there are limited data on whether adrenalectomy in patients with aldosterone-producing adenomas (APA) can improve glucose metabolism. In this study we evaluated changes in glucose metabolism, before and after surgery for APA. The subjects were 61 patients treated with unilateral adrenalectomy, localized by adrenal venous sampling. A 75g-oral glucose tolerance test (OGTT) was performed before and 1 year after adrenalectomy...
March 31, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28102204/the-prevalence-of-ctnnb1-mutations-in-primary-aldosteronism-and-consequences-for-clinical-outcomes
#17
Vin-Cent Wu, Shuo-Meng Wang, Shih-Chieh Jeff Chueh, Shao-Yu Yang, Kuo-How Huang, Yen-Hung Lin, Jian-Jhong Wang, Rory Connolly, Ya-Hui Hu, Celso E Gomez-Sanchez, Kang-Yung Peng, Kwan-Dun Wu
Constitutive activation of the Wnt pathway/β-catenin signaling may be important in aldosterone-producing adenoma (APA). However, significant gaps remain in our understanding of the prevalence and clinical outcomes after adrenalectomy in APA patients harboring CTNNB1 mutations. The molecular expression of CYP11B2 and gonadal receptors in adenomas were also explored. Adenomas from 219 APA patients (95 men; 44.2%; aged 50.5 ± 11.9 years) showed a high rate of somatic mutations (n = 128, 58.4%). The majority of them harbored KCNJ5 mutations (n = 116, 52...
January 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27975056/is-laparoendoscopic-single-site-adrenalectomy-a-feasible-alternative-in-treating-aldosterone-producing-adenoma
#18
Che-Hsiung Wu, Leay-Kiaw Er, Ya-Hui Hu, Chia Da Lin, Shih-Chieh Chueh, Yao-Chou Tsai
Objective. To compare laparoendoscopic single-site (LESS) and conventional multiport adrenalectomy in patients with aldosterone-producing adenoma (APA). Material and Methods. We retrospectively reviewed patients who had been clinically confirmed with unilateral APA and who underwent LESS or multiport adrenalectomy between 2009 and 2014. Perioperative data were obtained for all patients. Blood pressure and the levels of serum aldosterone, renin, and potassium were checked periodically. Results. We identified 45 APA patients in the LESS group and 71 in the multiport group...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27974594/complement-mediated-inhibition-of-adiponectin-regulates-perivascular-inflammation-and-vascular-injury-in-hypertension
#19
Cheng-Chao Ruan, Yu Ma, Qian Ge, Yan Li, Li-Min Zhu, Ying Zhang, Ling-Ran Kong, Qi-Hong Wu, Fanghong Li, Lixian Cheng, Allan Z Zhao, Ding-Liang Zhu, Ping-Jin Gao
Perivascular adipose tissue (PVAT)-derived adiponectin (APN) is a secreted adipokine that protects against hypertension-related cardiovascular injury. However, the regulation of APN expression in hypertension remains to be explored. In this study, we demonstrated that down-regulation of APN was associated with complement activation in the PVAT of desoxycorticosterone acetate (DOCA)-salt hypertensive mice. Complement 3-deficient hypertensive mice were protected from ANP decrease in the PVAT. APN deficiency blockaded the protective effects of complement inhibition against hypertensive vascular injury...
December 14, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27917596/plasma-adrenocorticotropic-hormone-but-not-aldosterone-is-correlated-with-blood-pressure-in-patients-with-aldosterone-producing-adenomas
#20
Hiroki Kobayashi, Akira Haketa, Ueno Takahiro, Hiromasa Otsuka, Sho Tanaka, Yoshinari Hatanaka, Yukihiro Ikeda, Masanori Abe, Noboru Fukuda, Masayoshi Soma
Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. The authors examined the levels of aldosterone, cortisol, renin, and adrenocorticotropic hormone (ACTH) measured at 12 am, 6 am, 12 pm, and 6 pm and BP in the early morning (6 am to 7 am), late morning (9 am to 11 am), and early evening (5 pm to 7 pm)...
December 5, 2016: Journal of Clinical Hypertension
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