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Article ; Online: Substantial changes in inflammatory and cardiovascular biomarkers in patients with autonomous cortisol secretion.

Ueland, Grethe Å / Methlie, Paal / Heie, Anette / Meling Stokland, Ann-Elin / Dahle, Anne Lise / Sævik, Åse B / Løvås, Kristian / Husebye, Eystein S

European journal of endocrinology

2023 Volume 189, Issue 1, Page(s) 78–86

Abstract: Objective: To map inflammatory biomarkers in patients with autonomous cortisol secretion (ACS) and overt Cushing syndrome (CS).: Method: Observational study including serum from prospectively included patients with ACS (n = 63), adrenal CS (n = 2), ... ...

Abstract	Objective: To map inflammatory biomarkers in patients with autonomous cortisol secretion (ACS) and overt Cushing syndrome (CS). Method: Observational study including serum from prospectively included patients with ACS (n = 63), adrenal CS (n = 2), pituitary CS (n = 8), and healthy subjects (n = 120). Serum samples were analysed for 92 inflammatory biomarkers using proximity extension assay (OLINK). Results: Combined, the ACS and CS patients displayed significant differences in levels of 49/92 inflammatory biomarkers (46 increased/3 decreased) compared with healthy controls. No differences in biomarker levels were found between ACS and overt CS, and none of the biomarkers correlated with the degree of hypercortisolism. Postoperative samples were available for 17 patients, median 24 months (range 6-40) after surgery and biochemical curation. There was no significant normalization of the biomarkers postoperatively. Conclusion: There was a systemic rise in inflammatory biomarkers in patients with ACS and CS, not correlated to the degree of hypercortisolism. These biomarkers were not normalized following biochemical cure.
MeSH term(s)	Humans ; Cushing Syndrome/diagnosis ; Cushing Syndrome/surgery ; Adrenal Gland Neoplasms ; Hydrocortisone ; Biomarkers ; Cardiovascular System
Chemical Substances	Hydrocortisone (WI4X0X7BPJ) ; Biomarkers
Language	English
Publishing date	2023-07-03
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1093/ejendo/lvad076
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Article ; Online: Impact of autofluorescence for detection of parathyroid glands during thyroidectomy on postoperative parathyroid hormone levels: parallel multicentre randomized clinical trial.

Bergenfelz, Anders / Barczynski, Marcin / Heie, Anette / Muth, Andreas / Passler, Christian / Schneider, Max / Wierzbicka, Paulina / Konturek, Alexander / Brauckhoff, Katrin / Elf, Anna-Karin / Dahlberg, Jakob / Hermann, Michael

The British journal of surgery

2023 Volume 110, Issue 12, Page(s) 1824–1833

Abstract: Background: Techniques for autofluorescence have been introduced to visualize the parathyroid glands during surgery and to reduce hypoparathyroidism after thyroidectomy.: Methods: This parallel multicentre RCT investigated the use of Fluobeam® LX to ... ...

Abstract	Background: Techniques for autofluorescence have been introduced to visualize the parathyroid glands during surgery and to reduce hypoparathyroidism after thyroidectomy. Methods: This parallel multicentre RCT investigated the use of Fluobeam® LX to visualize the parathyroid glands by autofluorescence during total thyroidectomy compared with no use. There was no restriction on the indication for surgery. Patients were randomized 1 : 1 and were blinded to the group allocation. The hypothesis was that autofluorescence enables identification and protection of the parathyroid glands during thyroidectomy. The primary endpoint was the rate of low parathyroid hormone (PTH) levels the day after surgery. Results: Some 535 patients were randomized, and 486 patients received an intervention according to the study protocol, 246 in the Fluobeam® LX group and 240 in the control group. Some 64 patients (26.0 per cent) in the Fluobeam® LX group and 77 (32.1 per cent) in the control group had low levels of PTH after thyroidectomy (P = 0.141; relative risk (RR) 0.81, 95 per cent c.i. 0.61 to 1.07). Subanalysis of 174 patients undergoing central lymph node clearance showed that 15 of 82 (18 per cent) in the Fluobeam® LX group and 31 of 92 (33 per cent) in the control group had low levels of PTH on postoperative day 1 (P = 0.021; RR 0.54, 0.31 to 0.93). More parathyroid glands were identified during operation in patients who had surgery with Fluobeam® LX, and fewer parathyroid glands in the surgical specimen on definitive histopathology. No specific harm related to the use of Fluobeam® LX was reported. Conclusion: The use of autofluorescence during thyroidectomy did not reduce the rate of low PTH levels on postoperative day 1 in the whole group of patients. It did, however, reduce the rate in a subgroup of patients. Registration number: NCT04509011 (http://www.clinicaltrials.gov).
MeSH term(s)	Humans ; Parathyroid Glands/surgery ; Thyroidectomy/adverse effects ; Thyroidectomy/methods ; Parathyroid Hormone ; Hypoparathyroidism/etiology ; Hypoparathyroidism/prevention & control ; Lymph Nodes ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Postoperative Complications/surgery ; Hypocalcemia/etiology
Chemical Substances	Parathyroid Hormone
Language	English
Publishing date	2023-09-27
Publishing country	England
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znad278
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Article ; Online: X-chromosome variants are associated with aldosterone producing adenomas.

Dutta, Ravi Kumar / Larsson, Malin / Arnesen, Thomas / Heie, Anette / Walz, Martin / Alesina, Piero / Gimm, Oliver / Söderkvist, Peter

Scientific reports

2021 Volume 11, Issue 1, Page(s) 10562

Abstract: Aldosterone-producing adenomas (APAs) are a major cause of primary aldosteronism (PA) and are characterized by constitutively producing aldosterone, which leads to hypertension. Several mutations have been identified in ion channels or ion channel- ... ...

Abstract	Aldosterone-producing adenomas (APAs) are a major cause of primary aldosteronism (PA) and are characterized by constitutively producing aldosterone, which leads to hypertension. Several mutations have been identified in ion channels or ion channel-associated genes that result in APAs. To date, no studies have used a genome-wide association study (GWAS) approach to search for predisposing loci for APAs. Thus, we investigated Scandinavian APA cases (n = 35) and Swedish controls (n = 60) in a GWAS and discovered a susceptibility locus on chromosome Xq13.3 (rs2224095, OR = 7.9, 95% CI = 2.8-22.4, P = 1 × 10
MeSH term(s)	Adenoma/genetics ; Adenoma/metabolism ; Aldosterone/biosynthesis ; Carrier Proteins/genetics ; Case-Control Studies ; Chromosomes, Human, X ; Cohort Studies ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Germ-Line Mutation ; Humans ; Male ; Middle Aged ; Nerve Tissue Proteins/genetics ; Polymorphism, Single Nucleotide ; Quantitative Trait Loci
Chemical Substances	Carrier Proteins ; MAGEE1 protein, human ; Nerve Tissue Proteins ; Aldosterone (4964P6T9RB)
Language	English
Publishing date	2021-05-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-89986-8
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Article: Feminizing adrenal tumor identified by plasma steroid profiling.

Vogt, Elinor Chelsom / Hammerling, Kathrin / Sorbye, Halfdan / Heie, Anette / Sulen, Andre / Ueland, Grethe / Husebye, Eystein / Methlie, Paal

Endocrinology, diabetes & metabolism case reports

2021 Volume 2021

Abstract: Summary: Feminizing estrogen-secreting adrenocortical carcinomas (ACCs) are exceedingly rare and carry a poor prognosis. The most common presenting trait is gynecomastia, but enlarged breasts are also a frequent clinical finding in healthy men. ... ...

Abstract	Summary: Feminizing estrogen-secreting adrenocortical carcinomas (ACCs) are exceedingly rare and carry a poor prognosis. The most common presenting trait is gynecomastia, but enlarged breasts are also a frequent clinical finding in healthy men. Biochemical evaluation may be challenging. As such, there is a high risk of delayed diagnosis and treatment opportunity. Here, we present a case with an estrogen-producing ACC where the abnormal steroid profile obtained at the time of initial workup was essential for the prompt diagnosis. Wider adoption of liquid chromatography mass spectrometry-based steroid assays has potential to improve early diagnosis of feminizing estrogen-secreting ACC. Learning points: Feminizing estrogen-secreting adrenocortical carcinomas (ACCs) are a rare, but an important differential diagnosis in men with rapidly developing gynecomastia. Biochemical evaluation is essential for a prompt diagnosis. Steroid hormone profiling using liquid chromatography mass spectrometry technology has the potential to improve early diagnosis of feminizing estrogen-secreting ACC.
Language	English
Publishing date	2021-11-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2785530-2
ISSN	2052-0573
ISSN	2052-0573
DOI	10.1530/EDM-21-0104
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Article ; Online: A somatic mutation in CLCN2 identified in a sporadic aldosterone-producing adenoma.

Dutta, Ravi Kumar / Arnesen, Thomas / Heie, Anette / Walz, Martin / Alesina, Piero / Söderkvist, Peter / Gimm, Oliver

European journal of endocrinology

2019 Volume 181, Issue 5, Page(s) K37–K41

Abstract: Objective: To screen for CLCN2 mutations in apparently sporadic cases of aldosterone-producing adenomas (APAs).: Description: Recently, CLCN2, encoding for the voltage-gated chloride channel protein 2 (ClC-2), was identified to be mutated in familial ...

Abstract	Objective: To screen for CLCN2 mutations in apparently sporadic cases of aldosterone-producing adenomas (APAs). Description: Recently, CLCN2, encoding for the voltage-gated chloride channel protein 2 (ClC-2), was identified to be mutated in familial hyperaldosteronism II (FH II). So far, somatic mutations in CLCN2 have not been reported in sporadic cases of APAs. We screened 80 apparently sporadic APAs for mutations in CLCN2. One somatic mutation was identified at p.Gly24Asp in CLCN2. The male patient had a small adenoma in size but high aldosterone levels preoperatively. Postoperatively, the patient had normal aldosterone levels and was clinically cured. Conclusion: In this study, we identified a CLCN2 mutation in a sporadic APA comprising about 1% of all APAs investigated. This mutation was complementary to mutations in other susceptibility genes for sporadic APAs and may thus be a driving mutation in APA formation.
MeSH term(s)	Adenoma/genetics ; Adenoma/metabolism ; Adenoma/surgery ; Adult ; Aldosterone/metabolism ; CLC-2 Chloride Channels ; Chloride Channels/genetics ; Gene Frequency ; Humans ; Male ; Mutation/genetics ; Norway/epidemiology ; Pituitary Neoplasms/genetics ; Pituitary Neoplasms/metabolism ; Pituitary Neoplasms/surgery ; Transcriptome/genetics
Chemical Substances	CLC-2 Chloride Channels ; Chloride Channels ; Aldosterone (4964P6T9RB)
Language	English
Publishing date	2019-09-20
Publishing country	England
Document type	Case Reports
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1530/EJE-19-0377
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Article ; Online: Adrenal Venous Sampling for Assessment of Autonomous Cortisol Secretion.

Ueland, Grethe Å / Methlie, Paal / Jøssang, Dag Eirik / Sagen, Jørn V / Viste, Kristin / Thordarson, Hrafnkell B / Heie, Anette / Grytaas, Marianne / Løvås, Kristian / Biermann, Martin / Husebye, Eystein S

The Journal of clinical endocrinology and metabolism

2018 Volume 103, Issue 12, Page(s) 4553–4560

Abstract: Context: Autonomous cortisol secretion (ACS) can be unilateral or bilateral irrespective of the presence of an adrenal tumor. A reliable method to distinguish between unilateral and bilateral ACS is lacking.: Objective: Evaluate the use of adrenal ... ...

Abstract	Context: Autonomous cortisol secretion (ACS) can be unilateral or bilateral irrespective of the presence of an adrenal tumor. A reliable method to distinguish between unilateral and bilateral ACS is lacking. Objective: Evaluate the use of adrenal venous sampling (AVS) to distinguish between unilateral and bilateral ACS. Design and methods: This was a prospective study of AVS in patients with adrenal tumors who received a diagnosis of ACS or adrenal Cushing syndrome (CS). Unilateral secretion was defined as >2.3-fold difference in cortisol levels between the two adrenal veins. Metanephrine levels were used to ascertain correct catheter position. Results were correlated with findings on CT and iodine-131-cholesterol scintigraphy. Results: Thirty-nine patients underwent AVS; there were no complications. The procedure was inconclusive in six patients and repeated with success in one, giving a success rate of 85%, and leaving 34 procedures for evaluation (adrenal CS, n = 2; ACS, n = 32). Of 14 patients with bilateral tumors, 10 had bilateral and 4 had unilateral overproduction. Of 20 patients with unilateral tumors, 11 had lateralization to the side of the tumor and the remaining had bilateral secretion. Cholesterol scintigraphy findings were concordant with those of AVS in 13 of 18 cases (72%) and discordant in 5 (28%). Conclusion: Laterality of ACS does not always correspond to findings on CT images. AVS is a safe and valuable tool for differentiation between unilateral and bilateral cortisol secretion and should be considered when operative treatment of ACS is a possibility.
MeSH term(s)	Adrenal Gland Neoplasms/blood ; Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/diagnosis ; Adrenal Glands/blood supply ; Adrenal Glands/diagnostic imaging ; Adrenal Glands/metabolism ; Adult ; Aged ; Catheterization/methods ; Cholesterol/administration & dosage ; Cholesterol/chemistry ; Contrast Media/administration & dosage ; Cushing Syndrome/blood ; Cushing Syndrome/complications ; Cushing Syndrome/diagnosis ; Diagnosis, Differential ; Feasibility Studies ; Female ; Femoral Vein/surgery ; Humans ; Hydrocortisone/blood ; Hydrocortisone/metabolism ; Hyperaldosteronism/blood ; Hyperaldosteronism/diagnosis ; Hyperaldosteronism/etiology ; Iodine Radioisotopes/administration & dosage ; Iodine Radioisotopes/chemistry ; Male ; Middle Aged ; Prospective Studies ; Radionuclide Imaging/methods ; Tomography, X-Ray Computed
Chemical Substances	Contrast Media ; Iodine Radioisotopes ; Iodine-131 ; Cholesterol (97C5T2UQ7J) ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2018-10-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/jc.2018-01198
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Article ; Online: Liquid biopsies and patient-reported outcome measures for integrative monitoring of patients with early-stage breast cancer: a study protocol for the longitudinal observational Prospective Breast Cancer Biobanking (PBCB) study.

Søiland, Håvard / Janssen, Emiel A M / Helland, Thomas / Eliassen, Finn Magnus / Hagland, Magnus / Nordgård, Oddmund / Lunde, Siri / Lende, Tone Hoel / Sagen, Jørn Vegard / Tjensvoll, Kjersti / Gilje, Bjørnar / Jonsdottir, Kristin / Gudlaugsson, Einar / Lode, Kirsten / Hagen, Kari Britt / Gripsrud, Birgitta Haga / Lind, Ragna / Heie, Anette / Aas, Turid /

Austdal, Marie / Egeland, Nina Gran / Bernklev, Tomm / Lash, Timothy L / Skartveit, Linn / Kroksveen, Ann Cathrine / Oltedal, Satu / Kvaløy, Jan Terje / Lien, Ernst A / Sleire, Linda / Mellgren, Gunnar

BMJ open

2022 Volume 12, Issue 4, Page(s) e054404

Abstract: Introduction: Breast cancer is still the most common malignancy among women worldwide. The Prospective Breast Cancer Biobank (PBCB) collects blood and urine from patients with breast cancer every 6 or 12 months for 11 years from 2011 to 2030 at two ... ...

Abstract	Introduction: Breast cancer is still the most common malignancy among women worldwide. The Prospective Breast Cancer Biobank (PBCB) collects blood and urine from patients with breast cancer every 6 or 12 months for 11 years from 2011 to 2030 at two university hospitals in Western Norway. The project aims to identify new biomarkers that enable detection of systemic recurrences at the molecular level. As blood represents the biological interface between the primary tumour, the microenvironment and distant metastases, liquid biopsies represent the ideal medium to monitor the patient's cancer biology for identification of patients at high risk of relapse and for early detection systemic relapse.Including patient-reported outcome measures (PROMs) allows for a vast number of possibilities to compare PROM data with biological information, enabling the study of fatigue and Quality of Life in patients with breast cancer. Methods and analysis: A total of 1455 patients with early-stage breast cancer are enrolled in the PBCB study, which has a one-armed prospective observational design. Participants consent to contribute liquid biopsies (i.e., peripheral blood and urine samples) every 6 or 12 months for 11 years. The liquid biopsies are the basis for detection of circulating tumour cells, circulating tumour DNA (ctDNA), exosomal micro-RNA (miRNA), miRNA in Tumour Educated Platelet and metabolomic profiles. In addition, participants respond to 10 PROM questionnaires collected annually. Moreover, a control group comprising 200 women without cancer aged 25-70 years will provide the same data. Ethics and dissemination: The general research biobank PBCB was approved by the Ministry of Health and Care Services in 2007, by the Regional Ethics Committee (REK) in 2010 (#2010/1957). The PROM (#2011/2161) and the biomarker study PerMoBreCan (#2015/2010) were approved by REK in 2011 and 2015 respectively. Results will be published in international peer reviewed journals. Deidentified data will be accessible on request. Trial registration number: NCT04488614.
MeSH term(s)	Adult ; Aged ; Biological Specimen Banks ; Biomarkers ; Breast Neoplasms/diagnosis ; Female ; Humans ; Liquid Biopsy ; MicroRNAs ; Middle Aged ; Neoplasm Recurrence, Local ; Observational Studies as Topic ; Patient Reported Outcome Measures ; Prospective Studies ; Quality of Life ; Tumor Microenvironment
Chemical Substances	Biomarkers ; MicroRNAs
Language	English
Publishing date	2022-04-29
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-054404
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Article ; Online: Clinical Characteristics and Long-Term Outcome of Primary Aldosteronism in a Norwegian Population.

Grytaas, Marianne Aardal / Strømsøy, Siri S / Rørvik, Jarle Tor / Arnes, Jarle Birger / Heie, Anette / Arnesen, Thomas / Jørstad, Melissa D / Nedrebø, Bjørn Gunnar / Jøssang, Dag Erik / Jensen, Dag Kjartan / Rørvik, Håvard D / Sagen, Jørn Vegard / Mellgren, Gunnar / Thordarson, Hrafnkell B / Husebye, Eystein Sverre / Løvås, Kristian

Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme

2017 Volume 49, Issue 11, Page(s) 838–846

MeSH term(s)	Adrenal Glands/diagnostic imaging ; Adult ; Aged ; Aged, 80 and over ; Cell Differentiation ; Female ; Follow-Up Studies ; Humans ; Hyperaldosteronism/diagnostic imaging ; Hyperaldosteronism/genetics ; Hyperaldosteronism/pathology ; Hyperaldosteronism/therapy ; Male ; Middle Aged ; Norway ; Reproducibility of Results ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2017-09-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80125-2
ISSN	1439-4286 ; 0018-5043
ISSN (online)	1439-4286
ISSN	0018-5043
DOI	10.1055/s-0043-118909
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Article ; Online: Outcome after surgery for primary hyperaldosteronism may depend on KCNJ5 tumor mutation status: a population-based study from Western Norway.

Arnesen, Thomas / Glomnes, Nina / Strømsøy, Siri / Knappskog, Stian / Heie, Anette / Akslen, Lars A / Grytaas, Marianne / Varhaug, Jan Erik / Gimm, Oliver / Brauckhoff, Michael

Langenbeck's archives of surgery

2013 Volume 398, Issue 6, Page(s) 869–874

Abstract: Background: Primary aldosteronism (PA) is a frequent cause (about 10 %) of hypertension. Some cases of PA were recently found to be caused by mutations in the potassium channel KCNJ5. Our objective was to determine the mutation status of KCNJ5 and seven ...

Abstract	Background: Primary aldosteronism (PA) is a frequent cause (about 10 %) of hypertension. Some cases of PA were recently found to be caused by mutations in the potassium channel KCNJ5. Our objective was to determine the mutation status of KCNJ5 and seven additional candidate genes for tumorigenesis: YY1, FZD4, ARHGAP9, ZFP37, KDM5C, LRP1B, and PDE9A and, furthermore, the surgical outcome of PA patients who underwent surgery in Western Norway. Methods: Twenty-eight consecutive patients with aldosterone-producing adrenal tumors (20 patients with single adenoma, 8 patients with unilateral multiple adenomas or hyperplasia) who underwent surgery were included in this study. All patients were operated on by uncomplicated laparoscopic total adrenalectomy. Genomic DNA was isolated from tumor and non-tumor adrenocortical tissue, and DNA sequencing revealed the mutation status. Results: Ten out of 28 (36 %) patients with PA displayed tumor mutations in KCNJ5 (p. G151R and L168R) while none were found in the corresponding non-tumor samples. No mutations were found in the other seven candidate genes screened. The presence of KCNJ5 mutations was associated with lower blood pressure and a higher chance for cure by surgery when compared to patients harboring the KCNJ5 wild type. Conclusions: KCNJ5 mutations are associated with a better surgical outcome. Preoperative identification of the mutation status might have impact on surgical strategy (total vs. subtotal adrenalectomy).
MeSH term(s)	Adrenal Gland Neoplasms/genetics ; Adrenal Gland Neoplasms/physiopathology ; Adrenal Gland Neoplasms/surgery ; Adrenalectomy/adverse effects ; Adrenalectomy/methods ; Adult ; Cohort Studies ; Female ; Follow-Up Studies ; G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics ; Gene Expression Regulation, Neoplastic ; Genetic Predisposition to Disease ; Humans ; Hyperaldosteronism/genetics ; Hyperaldosteronism/physiopathology ; Hyperaldosteronism/surgery ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Male ; Middle Aged ; Mutation ; Norway ; Postoperative Complications/genetics ; Postoperative Complications/physiopathology ; Retrospective Studies ; Risk Assessment ; Treatment Outcome
Chemical Substances	G Protein-Coupled Inwardly-Rectifying Potassium Channels ; KCNJ5 protein, human
Language	English
Publishing date	2013-06-19
Publishing country	Germany
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-013-1093-2
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Article: Clinical Characteristics and Long-Term Outcome of Primary Aldosteronism in a Norwegian Population

Grytaas, Marianne Aardal / Strømsøy, Siri S. / Rørvik, Jarle Tor / Arnes, Jarle Birger / Heie, Anette / Arnesen, Thomas / Jørstad, Melissa D. / Nedrebø, Bjørn Gunnar / Jøssang, Dag Erik / Jensen, Dag Kjartan / Rørvik, Håvard D. / Sagen, Jørn Vegard / Mellgren, Gunnar / Thordarson, Hrafnkell B. / Husebye, Eystein Sverre / Løvås, Kristian

Hormone and Metabolic Research

2017 Volume 49, Issue 11, Page(s) 838–846

Abstract: Primary aldosteronism (PA) is the most common cause of secondary hypertension (HT). We describe here clinical characteristics, diagnostic procedures, and long-term outcomes in a Norwegian population. All suspected PA patients investigated at a tertiary ... ...

Abstract	Primary aldosteronism (PA) is the most common cause of secondary hypertension (HT). We describe here clinical characteristics, diagnostic procedures, and long-term outcomes in a Norwegian population. All suspected PA patients investigated at a tertiary centre from 1998–2012 were retrospectively evaluated. Inclusion criteria were verified PA after confirmatory testing or otherwise considered highly likely PA. Clinical, biochemical, radiological, and adrenal vein sampling (AVS) findings were analysed. Surgically removed adrenals were re-evaluated histopathologically and tested for somatic mutations. All patients still alive by August 2014 were invited to a follow-up visit. One-hundred and eight patients were included, of whom 85% had a history of hypokalaemia. PA was verified by confirmatory testing in 83 (77%), and AVS performed in 95 (88%) patients. The proportion with AVS-confirmed bilateral PA increased during the study period. Sixty-eight patients (63%) underwent adrenalectomy. KCNJ5 mutations were found in 30% of the surgical specimens and were associated with female sex and a florid PA phenotype. Follow-up visits were undertaken in 73/108 (68%), of whom 52 adrenalectomised. After adrenalectomy, 83% were biochemically cured of PA, but only 21% were cured for HT. Female sex, a verified adenoma, and KCNJ5 mutations were associated with cure of HT. In conclusion, the majority of our patients had unilateral PA and hypokalaemia, indicating that patients with bilateral and milder PA may still be underdiagnosed. Female sex, a histopathological adenoma, and the presence of KCNJ5 mutations predicted cure of HT after adrenalectomy, but the overall cure rate of HT was low.
Keywords	primary aldosteronism ; KCNJ5 ; adrenal venous sampling ; adrenalectomy
Language	English
Publishing date	2017-09-18
Publisher	© Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80125-2
ISSN	1439-4286 ; 0018-5043
ISSN (online)	1439-4286
ISSN	0018-5043
DOI	10.1055/s-0043-118909
Database	Thieme publisher's database

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In stock of ZB MED Cologne/Königswinter

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Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito