Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2022) 86 OP2.3 | DOI: 10.1530/endoabs.86.OP2.3


1Queen Mary University London, London, United Kingdom; 2Saint Bartholomew’s Hospital, London, United Kingdom; 3Cambridge University, Cambridge, United Kingdom; 4Addenbrooke’s Hospital, Cambridge, United Kingdom; 5National University of Singapore, Singapore, Singapore; 6Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom; 7University of Birmingham, Birmingham, United Kingdom; 8King’s College London, London, United Kingdom


Introduction: In a prospective within-patient study (MATCH) 11C-metomidate PET-CT (MTO) was an accurate non-invasive alternative to adrenal vein sampling in the detection of unilateral PA1. Post-adrenalectomy (ADX), 24/78 (30%) patients achieved complete clinical success (PASO consensus) at 6 months, but 75% achieved reduction in B-type natriuretic peptide (BNP).

Aim: To determine: 1. the number of patients who sustain complete clinical success, and reduction in BNP, at 2 years, 2. whether tumour genotype associates with likelihood of sustained cure, and can be predicted from the baseline urinary 18-OH cortisol/cortisol (‘hybrid steroid’) ratio.

Results: 63/78 ADX patients have completed 2-year follow-up. 20 of the 24 patients (83%) with complete clinical success at 6 months continue to have an average home BP <135/85mmHg, off treatment, at 2 years. In 18/78 patients, the aldosterone-producing-adenoma had a KCNJ5 (K+-channel) mutation; 14 achieved complete clinical success at both 6 and 24 months. Two patients with a double-mutation of CTNNB1/GNAQ also showed complete clinical success at 6 and 24 months. By contrast, 20/78 ADX patients had a CACNA1D (Ca++-channel) mutation, of whom 3 and 1 patients, respectively, were clinically cured at 6 and 24 months. The hybrid steroid ratio at baseline, measured in 66/78 patients, separated patients with KCNJ5 mutations (6.4(SD2.7)) from other genotypes (1.3(SD0.7)). Plasma BNP, available in 44/78 ADX patients, decreased in 36/44 (mean (SD) reduction 27%, from 164 (248) to 84 (122) ng/l).

Conclusion: Complete cure of hypertension, achieved in a minority of ADX patients, is likely to be sustained for at least 2 years. Most complete cures are of patients with a KCNJ5 mutation, who are potentially predicted by their urine hybrid-steroid ratio. The majority of ADX patients have a substantial reduction in BNP, indicating the benefits, beyond cure of hypertension, of suppressing autonomous aldosterone production.

Reference 1. Wu et al. DOI:10.21203/rs.3.rs-1179128/v1.2021.

Volume 86

Society for Endocrinology BES 2022

Harrogate, United Kingdom
14 Nov 2022 - 16 Nov 2022

Society for Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.

Authors