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JOURNAL ARTICLE
Jie Ding, Xiang Li, Shengyan Liu, Yinjie Gao, Guoyang Zheng, Marcus Hacker, Yushi Zhang, Anli Tong, Li Huo
Our objective was to investigate the clinical value of 68 Ga-pentixafor PET/CT in subtype diagnosis of primary aldosteronism (PA) patients with adrenal micronodules less than 1 cm in diameter and compare it with the routine clinical methods. Methods: We used prospective enrollment of PA patients with adrenal micronodules identified by adrenal CT scans to undergo 68 Ga-pentixafor PET/CT. Patients were divided into surgically eligible and ineligible groups based on surgical pathology and postoperative follow-up or adrenal venous sampling (AVS) results...
January 2, 2024: Journal of Nuclear Medicine
#22
JOURNAL ARTICLE
Yingxing Wu, Zuxiang Wu, Jingan Rao, Huan Hu, Zhiqiang Chen, Chenkai Hu, Qiang Peng, Ping Li
OBJECTIVE: We aimed to investigate the predictive value of the CT findings combined with serum potassium levels for primary aldosteronism (PA) subtype diagnosis, with a particular interest in sex differences. METHODS: In this retrospective study, we eventually included 482 PA patients who underwent successful adrenal venous sampling (AVS) and had available data. We diagnosed the subjects as having either unilateral (n = 289) or bilateral PA (n = 193) based on AVS...
2023: Frontiers in Endocrinology
#23
JOURNAL ARTICLE
Gregory L Hundemer, Mohsen Agharazii, François Madore, Anand Vaidya, Jenifer M Brown, Alexander A Leung, Gregory A Kline, Eric Larose, Marie-Eve Piché, Andrew M Crean, Julie L V Shaw, Tim Ramsay, Bernhard Hametner, Siegfried Wassertheurer, Manish M Sood, Swapnil Hiremath, Marcel Ruzicka, Rémi Goupil
BACKGROUND: Primary aldosteronism, characterized by overt renin-independent aldosterone production, is a common but underrecognized form of hypertension and cardiovascular disease. Growing evidence suggests that milder and subclinical forms of primary aldosteronism are highly prevalent, yet their contribution to cardiovascular disease is not well characterized. METHODS: This prospective study included 1284 participants between the ages of 40 and 69 years from the randomly sampled population-based CARTaGENE cohort (Québec, Canada)...
January 9, 2024: Circulation
#24
JOURNAL ARTICLE
Hongjiao Gao, Li Li, Fei Chen, Yan Ren, Tao Chen, Haoming Tian
BACKGROUND: There is an increasing number of cases of aldosterone- and cortisol-producing adenomas (A/CPAs) reported in the context of primary aldosteronism (PA). Most of these patients have PA complicated with subclinical Cushing's syndrome; cases of apparent Cushing's syndrome (CS) complicated with aldosteronism are less reported. However, Co-secretory tumors were present in the right adrenal gland, a cortisol-secreting adenoma and an aldosterone-producing nodule (APN) were present in the left adrenal gland, and aldosterone-producing micronodules (APMs) were present in both adrenal glands, which has not been reported...
November 29, 2023: BMC Endocrine Disorders
#25
JOURNAL ARTICLE
Rongrong Wang, Yan Zhang, Runzhou Pan, Rongju Zhang, Yongcai Zhao
INTRODUCTION: Liddle syndrome is an autosomal dominant disorder characterized by hypertension, hypokalemia, low aldosterone levels, and reduced renin activity. Atypical Liddle syndrome can be easily misdiagnosed due to its clinical phenotypes resembling hyperaldosteronism. PATIENT CONCERN: The patient was diagnosed with primary aldosteronism due to hypertension and hypokalemia, and underwent left adrenalectomy. After the operation, the patient still had hypertension and hypokalemia that were not easy to control and correct, and had acute cerebral infarction...
November 24, 2023: Medicine (Baltimore)
#26
JOURNAL ARTICLE
Paola Parra Ramírez, Patricia Martín Rojas-Marcos, Miguel Paja Fano, Marga González Boillos, Begoña Pla Peris, Eider Pascual-Corrales, Ana María García Cano, Jorge Gabriel Ruiz-Sanchez, Almudena Vicente Delgado, Emilia Gómez Hoyos, Rui Ferreira, Iñigo García Sanz, Mònica Recasens Sala, Rebeca Barahona San Millan, María José Picón César, Patricia Díaz Guardiola, Carolina M Perdomo, Laura Manjón-Miguélez, Rogelio García Centeno, Juan Carlos Percovich, Ángel Rebollo Román, Paola Gracia Gimeno, Cristina Robles Lázaro, Manuel Morales-Ruiz, María Calatayud, Simone Andree Furio Collao, Diego Meneses, Miguel Antonio Sampedro Nuñez, Verónica Escudero Quesada, Elena Mena Ribas, Alicia Sanmartín Sánchez, Cesar Gonzalvo Diaz, Cristina Lamas, Raquel Guerrero-Vázquez, María Del Castillo Tous, Joaquín Serrano Gotarredona, Theodora Michalopoulou Alevras, Eva María Moya Mateo, Felicia A Hanzu, Marta Araujo-Castro
PURPOSE: To evaluate whether the clinical, biochemical and radiological features of patients with primary aldosteronism (PA) can predict both main subtypes of PA. METHODS: A retrospective multicenter study of PA patients followed in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Only patients with confirmed unilateral or bilateral PA based on adrenal venous sampling (AVS) and/or postsurgical biochemical cure after adrenalectomy were included. Supervised regression techniques were used for model development...
November 27, 2023: Endocrine
#27
REVIEW
M Araujo-Castro, E Pascual-Corrales, P Martín Rojas, P Parra Ramírez
Primary aldosteronism (PA) is the most common cause of secondary arterial hypertension. For unilateral cases, surgery offers the possibility of cure, with unilateral adrenalectomy being the treatment of choice, whereas bilateral forms of PA are treated mainly with mineralocorticoid receptor antagonists (MRA). The goals of treatment for PA due to either unilateral or bilateral adrenal disease include reversal of the adverse cardiovascular effects of hyperaldosteronism, normalization of serum potassium in patients with hypokalemia, and normalization of blood pressure...
2023: Hipertensión y Riesgo Vascular
#28
JOURNAL ARTICLE
Ze-Qun Lai, Yang Fu, Jian-Wei Liu, Hong-Jin Zhang, Huang Zhang, Ning-Peng Liang, Yi-Fei Dong
Superselective adrenal artery embolization (SAAE) is an effective treatment for patients with primary aldosteronism (PA). However, the impact of SAAE on renal function in the PA population remains uncertain. We investigated the estimated glomerular filtration rate (eGFR) and age, sex, body mass index, and diabetes-specific percentiles of eGFR residuals in 182 PA patients treated with SAAE in a prospective cohort from Nanchang SAAE in treating PA registry study. Data suggest that SAAE caused a significant decrease in eGFR from 91...
November 13, 2023: Hypertension Research: Official Journal of the Japanese Society of Hypertension
#29
JOURNAL ARTICLE
Rui Fu, Kathryn Walters, Michael L Kaufman, Katrina Koc, Amber Baldwin, Michael R Clay, Kaitlin J Basham, Katja Kiseljak-Vassiliades, Lauren Fishbein, Neelanjan Mukherjee
The human adrenal gland consists of concentrically organized, functionally distinct regions responsible for hormone production. Dysregulation of adrenocortical cell differentiation alters the proportion and organization of the functional zones of the adrenal cortex leading to disease. Current models of adrenocortical cell differentiation are based on mouse studies, but there are known organizational and functional differences between human and mouse adrenal glands. This study aimed to investigate the centripetal differentiation model in the human adrenal cortex and characterize aldosterone-producing micronodules (APMs) to better understand adrenal diseases such as primary aldosteronism...
November 2, 2023: Journal of the Endocrine Society
#30
REVIEW
Sabine Karam, Debbie L Cohen, Pauline Abou Jaoude, Janis Dionne, FangChao Linda Ding, Anika Garg, Elliot Koranteng Tannor, Rahul Chanchlani
The global prevalence of primary hypertension has been increasing both in children and in the adolescent and adult populations and can be attributed to changes in lifestyle factors with an obesity epidemic, increased salt consumption, and sedentary lifestyles. Childhood blood pressure is the strongest predictor of adult hypertension. Although hypertension in adults is associated strongly with an increased risk for cardiovascular disease, chronic kidney disease, and mortality, outcomes in children are defined less clearly...
July 2023: Seminars in Nephrology
#31
JOURNAL ARTICLE
Seiji Hoshi, Akifumi Onagi, Ryo Tanji, Ruriko Honda-Takinami, Kanako Matsuoka, Junya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Soichiro Ogawa, Yoshiyuki Kojima
BACKGROUND: Patients with bilateral primary aldosteronism (PA) generally are treated with antihypertensive drugs, but optimal treatment for patients with complications due to refractory hypertension has not been established. In this report, we present a case with bilateral PA who presented with persistent hypertension, despite treatment with 6 drugs, and left-dominant heart failure, which was improved after unilateral adrenalectomy. CASE PRESENTATION: A 61-year-old man was admitted to our hospital because of severe left-dominant heart failure...
November 7, 2023: BMC Endocrine Disorders
#32
JOURNAL ARTICLE
Byung-Chang Kim, Hyun-Ki Yoon, Kye Jin Park, Gun Ha Kim, Shin Jeong Pak, Douk Kwon, Jae Won Cho, Won Woong Kim, Yu-Mi Lee, Jung-Min Koh, Seung Hun Lee, Ki-Wook Chung, Tae-Yon Sung
BACKGROUND: Adrenal Computed tomography (CT) is a useful tool for locating adrenal lesion in primary aldosteronism(PA) patients. However, adrenal vein sampling(AVS) is considered as a gold standard for subtype diagnosis of PA. The aim of this study was to investigate the consistency of CT and AVS for the diagnosis of PA subtypes and evaluate the concordance of surgical outcomes. MATERIALS AND METHODS: This retrospective study included 264 PA patients having both CT and AVS...
November 2, 2023: International Journal of Surgery
#33
Sruthi Jinna, Rokana Taftaf, Firas G Petros, John Y Jun
We report a case of a 58-year-old woman with a history of hypertension diagnosed at aged 35 years, on 5 antihypertensive agents and a history of intermittent spontaneous hypokalemia, was found to have a 6-cm left adrenal mass on computed tomography scan of the abdomen. The unenhanced computed tomography attenuation of the adrenal mass was -16 Hounsfield units (HU). The biochemical evaluation showed potassium of 2.8 mEq/L (SI unit, mmol/L) (reference range, 3.5-5.0), plasma aldosterone concentration of 61...
March 2023: JCEM Case Rep
#34
Matea Crnković Ćuk, Ana Kovačević, Orjena Žaja, Marija Požgaj Šepec, Goran Roić, Bernardica Valent Morić, Ivana Trutin
We present a case of transient form of type 1 pseudohypoaldosteronism (S-PHA) in a 1.5-month-old male infant who presented with lethargy, failure to thrive, severe hyponatremia (Na=118 mmol/L), hypochloremia (Cl=93 mmol/L) and fever due to urinary tract infection. Potassium levels were normal. Markedly elevated serum aldosterone level and elevated serum renin confirmed the diagnosis of pseudohypoaldosteronism. Renal ultrasound showed grade III hydronephrosis on the left kidney while contrast-enhanced voiding urosonography excluded the existence of vesicoureteral reflux, which raised suspicion of obstructive uropathy at the level of vesicoureteral junction...
December 2022: Acta Clinica Croatica
#35
JOURNAL ARTICLE
John W Funder
There are mounting data that at least 30% of hypertensives who are appropriately screened have primary aldosteronism (PA), rather than the commonly reported figure of 5% to 10%. Second, there are similar data that undertreated patients with PA have a 3-fold higher risk profile than essential hypertensives with the same blood pressure levels. Third, clinicians managing hypertension measure success as sustainable lowering of blood pressure; untreated hypertensive patients with PA are thus in double jeopardy. Finally, and crucially, fewer than 1% of patients with hypertension are ever screened-let alone investigated-for PA...
December 2023: Hypertension
#36
JOURNAL ARTICLE
Chen Fang, Jun Dai, Juping Zhao, Xin Huang, Wei He, Jianzhong Xu, Fukang Sun
Primary aldosteronism (PA) with unilateral adrenal disease can be cured or improved by adrenalectomy. Adrenal venous sampling (AVS) is recommended to identify patients for surgical management. However, surgeries based on computed tomography (CT) images are only advocated for PA patients aged <35 with visible unilateral adenoma. Herein, we aimed to compare CT-based and AVS-based surgery outcomes for PA patients with visible unilateral adenomas for different age groups. A total of 178 PA patients who underwent unilateral adrenalectomy between June 2018 and January 2021 were included in the study based on CT (n = 54) or AVS (n = 124)...
October 4, 2023: Journal of Clinical Hypertension
#37
JOURNAL ARTICLE
Arijit Singha, Pradip Mukhopadhyay, Sujoy Ghosh
BACKGROUND: Adrenal insufficiency (AI) in HbE/Beta thalassemia, including evaluation of mineralocorticoid axis had not been studied. AIMS AND OBJECTIVES: In this study we attempted to evaluate the prevalence of AI in HbE/Beta thalassemia and wanted to determine if the prevalence of AI varied according to severity of HbE/Beta thalassemia and transfusion requirements. METHODS: In this observational, cross-sectional study, one hundred four patients with HbE/Beta thalassemia were evaluated...
September 29, 2023: Journal of Clinical Endocrinology and Metabolism
#38
JOURNAL ARTICLE
Subhanudh Thavaraputta, Patompong Ungprasert, Selma F Witchel, Pouneh K Fazeli
OBJECTIVE: Anorexia nervosa is a primary psychiatric disorder characterized by self-induced negative energy balance. A number of hormonal responses and adaptations occur in response to starvation and low body weight including changes in adrenocortical hormones. Our objective was to systematically review adrenocortical hormone levels in anorexia nervosa. DESIGN/METHODS: We searched MEDLINE and EMBASE for studies that reported at least one adrenocortical hormone, including dehydroepiandrosterone (DHEA), DHEA-sulphate (DHEA-S), progesterone, 17-hydroxyprogesterone, pregnenolone, cortisol (serum, urine, cerebrospinal fluid, and hair sample), aldosterone, androstenedione, and testosterone in patients with anorexia nervosa and normal-weight healthy controls from inception until October 2021...
September 1, 2023: European Journal of Endocrinology
#39
Asiya Jatoi, Yasser Haider-Badenhorst
Cushing's syndrome with concurrent primary aldosteronism (PA) is a rare presentation, and establishing an early diagnosis is imperative to preventing morbidity and long-term sequelae. The diagnosis is established by sequential lab work, showing an elevated cortisol and aldosterone level. Taking the above into consideration, it is evident that repeatedly negative results on all three tests can present an extremely challenging case. In this report, we discuss a female who presented with an adrenal incidentaloma and features suggestive of primary hyperaldosteronism as well as Cushing's syndrome but no elevations in serum, urine, or salivary cortisol...
July 2023: Curēus
#40
JOURNAL ARTICLE
Yang Peng, Guanglei Tang, Mengya Sun, Shuang Yu, Yanglei Cheng, Yu Wang, Weiwei Deng, Yanbing Li, Jian Guan
OBJECTIVE: To assess the feasibility of spectral CT-derived extracellular volume (ECV) for differentiating aldosterone-producing nodules (APN) from nonfunctioning adrenal nodules (NFN). METHODS: Sixty-nine patients with biochemically and histologically confirmed unilateral APN (34) and NFN (35) as well as 23 patients with bilateral APN (19) and NFN (27) confirmed biochemically and by adrenal vein sampling (AVS) were enrolled in this retrospective study from October 2020 to April 2022...
August 11, 2023: European Radiology
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