Endocrine Abstracts

Introduction: Hypoaldosteronism can be induced by a deficit of aldosterone production (AldDef) or a mineralocorticoid resistance (MinRes). Experts have proposed to use hyperkalemia-based aldosterone values for this purpose. However, there is no a range of aldosterone values indicating one of this type of hypoaldosteronism. In 2008, Adam W. R.1 hypothesized that the factored aldosterone (FAldo) could be useful differentiating hypoaldosteronism secondary to MinRes fro...

Introduction: Hypoaldosteronism is characterized by the development of hyperkalemia, but can also induce hypovolemic hyponatremia. Trimethroprim can cause hypoaldosteronism through mineralocorticoid resistance. That hypoaldosteronism can induce hyponatremia in absence of Addison’s disease has been questioned. We studied the electrolyte disturbances found following initiation of trimetroprim therapy.Material and methods: Retrospective, analytical. La...

Introduction: Primary hyperparathyroidism (PHP) has been postulated to be a cause of primary hyperaldosteronism (PHA). In fact, PTH receptors have been detected in aldosteronoma tissue. Hyperaldosteronism can also induce elevation of PTH levels, as increased circulating volume increases calciuria, with secondary elevation of PTH levels as serum calcium levels rise. We studied the prevalence of PHP in a group of patients diagnosed with PHA either following or simultaneously wit...

Inroduction: Polydipsia -excessive oral intake of liquids, with/without thirst- can induce euvolemic hyponatremia. Adequate inhibition of AVP secretion induced by low plasma osmolality (POsm) is reflected in a urinary osmolality (UOsm) ≤100 mOsm/kg. However, increased fluid intake can also reveal underlying non-osmotic AVP secretion, induced by pain, nausea, and/or SIADH, with UOsm >100. Iatrogenic polydipsia is characterized by increased liquid intake without thirst...

Introduction: Primary hyperaldosteronism (PH) is characterized by autonomous adrenal aldosterone (A) hypersecretion. Unilateral adrenalectomy is the treatment of choice, when adrenal vein sampling (AVS) indicates lateralization of A secretion. To assure that each adrenal vein (AV) has been correctly sampled, cortisol levels in each adrenal vein must be higher than in the inferior vena cava. The adrenal gland cortisol/vena cava cortisol ratio is referred to as the selectivity i...

Introduction: Hypoaldosteronism (HA), a cause of hypovolemic hyponatremia (HN) with urinary(U) sodium(Na) loss, is often underdiagnosed. We studied 28 patients with an episode of HA-induced moderate/severe hyponatremia.Methods: Retrospective 2012–2015. In all patients, Nadir(N) serum(S) Na <130 mmol/l (corrected for total proteins and glycemia), low internal yugular venous pressure, low ocular pressure. Addison’s Disease ruled (ACTH, cortis...

Introduction: ESE guidelines state a risk for overcorrection of serum sodium levels (SNa) with vaptans. We present the results of our protocol for initiation of tolvaptan(TV) therapy in SIADH.Methods: Retrospective (2011–15). 86 patients with SIADH-induced mild/moderate hyponatremia received TV:7.5 mg day 1, ad-libitum liquids, no other Na-raising therapies. Conventional hospitalization (CH):66/86, day hospital (DH):20/86. Glycemia-corrected SNa det...

Introduction: Hyperaldosteronism can induce elevated parathyroid hormone (PTH) levels, presumably by increasing calciuria. Furthermore, PTH stimulates aldosterone secretion in vitro, and increases angiotensin–II-stimulated aldosterone release. In a patient with hyperaldosteronism and hyperparathyroidism, PTH receptors were detected in aldosteronoma tissue. We present three patients sent to an endocrinologist for treatment/follow-up of primary hyperparathyroidism,...

Introduction: Control of hypertension (HT) is essential to reduce cardiovascular events in diabetic patients (DPts). However, studies indicate that only 50% of DPts with treated hypertension present adequate blood pressure (BP) control. Yet Endocrine-Society-Guideline (ESG) screening for primary hyperaldosteronism (PHA) is rarely applied. Furthermore, in patients with essential hypertension (EH), longer-acting hypertension medication (HM) improves 24-hour BP when compared to r...

Introduction: Tolvaptan is the only V2-receptor antagonist authorized for use in Europe in patients with SIADH. Its initiation requires hospitalization. Our goal was to analyze the safety and efficacy of tolvaptan started in a Hospital Day-Ward.Material and methods: Retrospective descriptive study of 33 ambulatory patients with mild/moderate SIADH-induced chronic sustained hyponatremia initiating tolvaptan therapy in the Day-Ward of a tertiary center ove...