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Primary aldosteronism with normal aldosterone

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https://www.readbyqxmd.com/read/29692992/tolvaptan-for-primary-aldosteronism-and-autosomal-dominant-polycystic-kidney-disease-a-case-report
#1
Kyohei Kunizawa, Junichi Hoshino, Hiroki Mizuno, Tatsuya Suwabe, Keiichi Sumida, Masahiro Kawada, Masayuki Yamanouchi, Akinari Sekine, Noriko Hayami, Rikako Hiramatsu, Eiko Hasegawa, Naoki Sawa, Kenmei Takaichi, Shigeru Shibata, Yoshifumi Ubara
A 59-year-old Japanese woman was admitted for evaluation of muscle weakness. Autosomal dominant polycystic kidney disease had been diagnosed at the age of 47 years, followed by primary aldosteronism at 53 years. At the age of 58, tolvaptan was started (60 mg/day) to treat her renal disease. After 8 months of tolvaptan therapy, hypokalemia-related muscle weakness became prominent, and hypertension became refractory. Finally, treatment with low-dose tolvaptan (30 mg/day) and high-dose spironolactone (100 mg/day) normalized serum potassium and the blood pressure...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29678284/aberrant-g-protein-coupled-hormone-receptor-in-adrenal-diseases
#2
REVIEW
Matthieu St-Jean, Nada El Ghorayeb, Isabelle Bourdeau, André Lacroix
The regulation of cortisol or aldosterone production when ACTH of pituitary origin or the renin-angiotensin systems are suppressed in primary adrenal Cushing's syndrome or in primary aldosteronism is exerted by diverse genetic and molecular mechanisms. In addition to recently identified mutations in various genes implicated in the cyclic AMP or ion channel pathways, steroidogenesis is not really autonomous as it is frequently regulated by the aberrant adrenocortical expression of diverse hormone receptors, particularly G-protein coupled hormone receptors (GPCR) which can substitute for the normal function of ACTH or angiotensin-II...
April 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29659888/randomized-placebo-controlled-trial-to-evaluate-effects-of-eplerenone-on-metabolic-and-inflammatory-indices-in-hiv
#3
Suman Srinivasa, Kathleen V Fitch, Kimberly Wong, Timothy K O'Malley, Patrick Maehler, Karen L Branch, Sara E Looby, Tricia H Burdo, Edgar L Martinez-Salazar, Martin Torriani, Shannon H Lyons, Julian Weiss, Meghan Feldpausch, Takara L Stanley, Gail K Adler, Steven K Grinspoon
Context: HIV-infected individuals demonstrate unique RAAS physiology, with increased RAAS activation in association with visceral adiposity, insulin resistance, and inflammation. A physiologically-based treatment approach targeting mineralocorticoid receptor (MR) blockade may improve metabolic and inflammatory indices in HIV. Objective: To investigate effects of eplerenone on insulin sensitivity, inflammatory indices and other metabolic parameters in HIV. Design: Six month, double-blind, randomized, placebo-controlled trial...
April 5, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29555192/arterial-stiffness-evaluated-by-pulse-wave-velocity-is-not-predictive-of-the-improvement-in-hypertension-after-adrenal-surgery-for-primary-aldosteronism-a-multicentre-study-from-the-french-european-society-of-hypertension-excellence-centres
#4
Béatrice Bouhanick, Jacques Amar, Laurence Amar, Philippe Gosse, Xavier Girerd, Yves Reznik, Claire Mounier-Vehier, Jean Philippe Baguet, Pierre Boutouyrie, Benoit Lepage, Pierre Lantelme, Bernard Chamontin
BACKGROUND: Predictive factors associated with normal blood pressure (BP) after unilateral adrenalectomy for primary aldosteronism (PA) are not clearly identified. AIMS: To evaluate the predictive value of arterial stiffness before surgery on BP after surgery. METHODS: During 2009-2013, 96 patients with PA due to unilateral adrenal adenoma who underwent surgery were enrolled in a multicentre open-label, prospective study. Aortic pulse wave velocity (PWV) was assessed before surgery...
March 16, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29467196/specific-activation-of-the-alternative-cardiac-promoter-of-cacna1c-by-the-mineralocorticoid-receptor
#5
Thassio R Mesquita, Gaëlle Auguste, Débora Falcón, Gema Ruiz-Hurtado, Rogelio Salazar-Enciso, Jessica Sabourin, Florence Lefebvre, Say Viengchareun, Hussein Kobeissy, Patrick Lechène, Valérie Nicolas, Amaya Fernandez-Celis, Susana Gómez, Sandra Lauton Santos, Eric Morel, Angelica Rueda, Natalia López-Andrés, Ana Maria Gómez, Marc Lombès, Jean-Pierre Benitah
RATIONALE: The MR (mineralocorticoid receptor) antagonists belong to the current therapeutic armamentarium for the management of cardiovascular diseases, but the mechanisms conferring their beneficial effects are poorly understood. Part of the cardiovascular effects of MR is because of the regulation of L-type Cav 1.2 Ca2+ channel expression, which is generated by tissue-specific alternative promoters as a long cardiac or short vascular N-terminal transcripts. OBJECTIVE: To analyze the molecular mechanisms by which aldosterone, through MR, modulates Cav 1...
March 30, 2018: Circulation Research
https://www.readbyqxmd.com/read/29436637/nicotinamide-phosphoribosyltransferase-and-the-hypothalamic-pituitary-adrenal-axis-of-the-rat
#6
Piotr Celichowski, Karol Jopek, Paulina Milecka, Marta Szyszka, Marianna Tyczewska, Ludwik K Malendowicz, Marcin Ruciński
Nicotinamide phosphoribosyltransferase (Nampt), also termed visfatin, catalyses the rate‑limiting step in the nicotinamide adenine dinucleotide (NAD) salvage pathway. In addition to its intracellular function (iNampt), extracellular Nampt (eNampt) also affects numerous intracellular signalling pathways. The current study investigated the role of Nampt in the regulation of the hypothalamic‑pituitary‑adrenal (HPA) axis in rats. At 1 h after intraperitoneal administration of eNampt (4 µg/100 g) in adult male rats, serum adrenocorticotropic hormone(ACTH) and aldosterone levels remained unchanged, while corticosterone levels were notably elevated compared with the control group, as determined by ELISA...
April 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29432258/overview-of-aldosterone-related-genetic-syndromes-and-recent-advances
#7
Maria-Christina Zennaro, Fabio L Fernandes-Rosa, Sheerazed Boulkroun
PURPOSE OF REVIEW: Primary aldosteronism is the most common form of secondary hypertension. Early diagnosis and treatment are key to cure of hypertension and prevention of cardiovascular complications. Recent genetic discoveries have improved our understanding on the pathophysiology of aldosterone production and triggered the development of new diagnostic procedures and targeted treatments for primary aldosteronism. RECENT FINDINGS: Different inherited genetic abnormalities distinguish specific forms of familial hyperaldosteronism...
June 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29390277/a-rare-case-report-of-bilateral-common-and-internal-iliac-arterial-fibromuscular-dysplasia-coexisted-dissection-aneurysm-and-stenosis
#8
Luyun Fan, Wenjun Ma, Huimin Zhang, Jun Cai
RATIONALE: Iliac arterial fibromuscular dysplasia (FMD) was rarely reported and its demographic, clinical, and imaging features have not been precisely described resulting in uncertain therapeutic methods. PATIENT CONCERNS: A 31-year-old man was referred because of 3-month-ago onset hypertension, low serum potassium, and a small-sized right kidney with normal renal artery under ultrasound examination. This patient was suspected of primary aldosteronism, whereas spirolactone was poorly effective...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29288290/complete-remission-of-hypertension-in-a-hemodialysis-patient-after-adrenalectomy-for-primary-aldosteronism-and-renal-transplantation
#9
Daisuke Watanabe, Satoshi Morimoto, Noriyoshi Takano, Shihori Kimura, Yasufumi Seki, Kanako Bokuda, Midori Sasaki-Yatabe, Junichi Yatabe, Hiromi Onizuka, Tomoko Yamamoto, Takashi Ando, Atsuhiro Ichihara
A 64-year-old man was admitted to our hospital for the hormonal evaluation of a right adrenal adenoma. He had been diagnosed with severe proteinuria and hypertension, and antihypertensive treatment was started at the age of 60. His renal function gradually declined, and hemodialysis was begun at the age of 64. Since his blood pressure was uncontrollable and resistant to antihypertensive treatment, an endocrinological examination was performed for an incidental right adrenal mass detected by computed tomography...
December 29, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29279316/targeting-cxcr4-cxc-chemokine-receptor-type-4-for-molecular-imaging-of-aldosterone-producing-adenoma
#10
Britta Heinze, Carmina T Fuss, Paolo Mulatero, Felix Beuschlein, Martin Reincke, Mona Mustafa, Andreas Schirbel, Timo Deutschbein, Tracy Ann Williams, Yara Rhayem, Marcus Quinkler, Nada Rayes, Silvia Monticone, Vanessa Wild, Celso E Gomez-Sanchez, Anna-Carinna Reis, Stephan Petersenn, Hans-Juergen Wester, Saskia Kropf, Martin Fassnacht, Katharina Lang, Ken Herrmann, Andreas K Buck, Christina Bluemel, Stefanie Hahner
Primary aldosteronism is the most frequent cause of secondary hypertension and is associated with increased morbidity and mortality compared with hypertensive controls. The central diagnostic challenge is the differentiation between bilateral and unilateral disease, which determines treatment options. Bilateral adrenal venous sampling, currently recommended for differential diagnosis, is an invasive procedure with several drawbacks, making it desirable to develop novel noninvasive diagnostic tools. When investigating the expression pattern of chemokine receptors by quantitative real-time polymerase chain reaction and immunohistochemistry, we observed high expression of CXCR4 (CXC chemokine receptor type 4) in aldosterone-producing tissue in normal adrenals, adjacent adrenal cortex from adrenocortical adenomas, and in aldosterone-producing adenomas (APA), correlating strongly with the expression of CYP11B2 (aldosterone synthase)...
February 2018: Hypertension
https://www.readbyqxmd.com/read/29238437/persistent-primary-aldosteronism-despite-iatrogenic-adrenal-hemorrhage-after-adrenal-vein-sampling
#11
Keisuke Okamura, Tetsu Okuda, Kazuyuki Shirai, Ichiro Abe, Kunihisa Kobayashi, Tatsu Ishii, Seiji Haraoka, Hidenori Urata
Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage...
January 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29237382/renin-activity-and-aldosterone-assay-among-nigerians-with-hypertension-and-normotension-an-insight-into-normative-values-and-clinical-correlates
#12
Adeseye Abiodun Akintunde, Afolabi Salawu, Boluwatife Adeniyi
OBJECTIVES: Plasma renin activity (PRA) and aldosterone tend to differ between Blacks and Caucasians and studies are very scarce among Africans. We therefore aimed to determine the normative value of plasma renin activity and serum aldosterone among school teachers in Nigeria with normal blood pressure compared with their hypertensive counterparts and relevant clinical/demographic associations. METHODS: Plasma renin activity and serum aldosterone were measured using the kits provided by Diagnostic Biochem, Canada among randomly selected school teachers recruited as part of a study to assess their total cardiovascular risks...
December 13, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/29207045/effect-of-atractylodes-macrocephala-rhizoma-on-isoproterenol%C3%A2-induced-ventricular-remodeling-in-rats
#13
Xiao-Hua Cui, Hui-Lin Wang, Rong Wu, Ping-An Yao, Ke-Zhao Wei, Jian-Ping Gao
Myocardial infarction (MI) is the primary cause of ventricular remodeling (VR). The aim of the present study was to determine the effect of Atractylodis macrocephalae rhizoma (AMR) on VR induced by isoproterenol (ISO) in rats. Male Sprague Dawley rats were randomly divided into the normal control, ISO‑induced and AMR groups. Rats in the ISO‑induced and AMR groups were subcutaneously injected with 85 mg/kg/day ISO for two consecutive days. Compared with the ISO‑induced group, AMR normalized the levels of hemodynamic parameters, markedly attenuated myocardial pathological damage, decreased the level of N‑terminal prohormone of brain natriuretic peptide, and inhibited cardiac hypertrophy and myocardial fibrosis...
February 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29202495/disordered-cyp11b2-expression-in-primary-aldosteronism
#14
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/29198769/subtyping-of-primary-aldosteronism-with-adrenal-vein-sampling-hormone-and-side-specific-effects-of-cosyntropin-and-metoclopramide
#15
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/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
#16
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
https://www.readbyqxmd.com/read/29156052/primary-adrenal-insufficiency-managing-mineralocorticoid-replacement-therapy
#17
Daniela Esposito, Daniela Pasquali, Gudmundur Johannsson
Context: Mineralocorticoid (MC) replacement therapy in patients with primary adrenal insufficiency (PAI) was introduced more than 60 years ago. Still, there are limited data on how MC substitution should be optimized, because MC dosing regimens have only been systematically investigated in a few studies. We review the management of current standard MC replacement therapy in PAI and its plausible impact on outcome. Design: Using PubMed, we conducted a systematic review of the literature from 1939 to 2017, with the following keywords: adrenal insufficiency, MC deficiency, aldosterone, cardiovascular disease, hypertension, and heart failure...
February 1, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29129366/contralateral-suppression-of-aldosterone-at-adrenal-venous-sampling-predicts-hyperkalemia-following-adrenalectomy-for-primary-aldosteronism
#18
Omair A Shariq, Irina Bancos, Patricia A Cronin, David R Farley, Melanie L Richards, Geoffrey B Thompson, William F Young, Travis J McKenzie
BACKGROUND: We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism. METHODS: A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5...
January 2018: Surgery
https://www.readbyqxmd.com/read/29099925/quality-of-life-in-primary-aldosteronism-a-comparative-effectiveness-study-of-adrenalectomy-and-medical-treatment
#19
Marieke Velema, Tanja Dekkers, Ad Hermus, Henri Timmers, Jacques Lenders, Hans Groenewoud, Leo Schultze Kool, Johan Langenhuijsen, Aleksander Prejbisz, Gert-Jan van der Wilt, Jaap Deinum
Context: In primary aldosteronism (PA), two subtypes are distinguished: aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH). In general, these are treated by adrenalectomy (ADX) and mineralocorticoid receptor antagonists (MRA), respectively. Objective: To compare the effects of surgical treatment and medical treatment on quality of life (QoL). Design: Post hoc comparative effectiveness study within the Subtyping Primary Aldosteronism: A Randomized Trial Comparing Adrenal Vein Sampling and Computed Tomography Scan (SPARTACUS) trial...
January 1, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29092077/significance-of-computed-tomography-and-serum-potassium-in-predicting-subtype-diagnosis-of-primary-aldosteronism
#20
Hironobu Umakoshi, Mika Tsuiki, Yoshiyu Takeda, Isao Kurihara, Hiroshi Itoh, Takuyuki Katabami, Takamasa Ichijo, Norio Wada, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi Takahashi, Minemori Watanabe, Yuichi Matsuda, Hiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Koichi Yamamto, Atsushi Ogo, Toshihiko Yanase, Tomoko Suzuki, Mitsuhide Naruse
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. Patients: A total of 1591 patients with PA were classified into four groups according to CT findings and potassium status...
March 1, 2018: Journal of Clinical Endocrinology and Metabolism
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