Endocrine Abstracts

Pheochromocytoma-Paraganglioma (PPGL) is a rare but important tumour with non-specific presentations that overlap with extremely common entities such as anxiety, hypertension, acute illness and episodic ‘spells.’ Assessment of urine normetanephrine or metanephrine(UNM-M) in real life practice, where PPGL is very rare and PPGL mimics are extremely common, may show overlap in results with loss of specificity depending on the reference range chosen. We performed a retro...

Background: Subtyping of primary aldosteronism (PA) using imaging and adrenal vein sampling (AVS) can yield discordant results. Varying interpretation criteria in determining AVS lateralization may affect discordance rates.Methods: We identified 337 consecutive patients with PA who underwent AVS at a quaternary care centre between August 2006 and February 2018. Patient demographics, laboratory results, diagnostic imaging, AVS results, and pathology were ...

Background: Negative imaging in the work-up for unilateral (surgical) primary aldosteronism (PA) presents a diagnostic dilemma. Clinicians may assume bilateral disease and treat medically or may proceed to adrenal vein sampling (AVS) to try to localize a unilateral source of aldosterone secretion. However, AVS is not without cost, risk, and limited access. We describe AVS results among imaging-negative PA patients.Methods: We identified 96 patients with ...

Background: Primary aldosteronism (PA) accounts for a significant proportion of patients with hypertension. There has been a focus on ACTH in the pathogenesis of aldosterone secretion even with suppressed renin. With the link between psychological stress and cardiovascular disease as well as the association between anxiety and PA, there may be broader neurohormonal “stress” stimuli that modulate aldosterone production in PA patients, beyond the HPA axis. PA patients ...

Background: Primary aldosteronism (PA) accounts for a significant proportion of patients with hypertension. There has been a focus on ACTH in the pathogenesis of aldosterone secretion even with suppressed renin. With the link between psychological stress and cardiovascular disease as well as the association between anxiety and PA, there may be broader neurohormonal “stress” stimuli that modulate aldosterone production in PA patients, beyond the HPA axis. PA patients ...

Introduction: Adrenal vein sampling (AVS) is considered gold-standard for diagnosis of unilateral primary aldosteronism (PA), and necessary pre-surgery. Imaging-AVS discordance may occur in up to 30-40% of PA-AVS series, and presents a diagnostic dilemma which may preclude surgery. Lateralization by AVS is defined as the ratio of aldosterone concentrations normalized by cortisol from each adrenal vein, and is thus sensitive to any pathologic asymmetry in corti...