Endocrine Abstracts

Case history: A previously well 45-year-old lady presented with a 3-year history of hypertension initially diagnosed at a routine health check. Her blood pressure (BP) was 170-180/90-100 mmHg.Investigations: Showed hypokalaemia (K+= 3 mmol/l; NR 3.5-5.3 mmol/l), raised aldosterone (976pmol/l; NR 100-500pmol/l) and supressed renin activity (<0.2nmol/l/h), meeting criteria for diagnosing primary aldosteronism (PA). CT adrenals showed a 2.5 cm left adre...

Introduction: Adrenal venous sampling (AVS) is the criterion standard method of lateralisation in primary aldosteronism (PA). Despite this pivotal role, there is limited consensus and significant variability between centres related to many of the technical aspects of AVS. In this study, we sought to address whether variations in two different technical aspects of AVS altered parameters and interpretation, namely: 1. Peripheral sample site 2. Method of adrenal vein (AV) venesec...

Background: After adrenalectomy (ADX) for primary aldosteronism (PA), approximately 30% of patients achieve clinical success (normalisation of home BP); many additional patients report feeling subjectively better. We used the non-randomised MATCH study1 to further assess quality of life (QoL) changes in participants.Objective: Assess QoL using the 36-item Short Form Health Survey (SF-36) after surgical treatment of unilateral PA and medical treatment of ...

Primary aldosteronism (PA) is the potentially curable cause of high-risk hypertension in 5-10% of unselected patients. Diagnosis and lateralisation of PA is challenging and complex. Outcomes post total adrenalectomy, the standard treatment for unilateral aldosterone producing adenomas (APAs), are variable. Between 30-60% are cured (1), but prediction of outcome is unreliable, and some patients are reluctant to have abdominal surgery to remove a whole adrenal gland. Endoscopic ...

Introduction: Our MATCH study demonstrated 11-C ligand MTO was non-inferior to adrenal vein sampling in predicting surgical outcomes of adrenalectomy in patients with PA. The 20-min half-life of 11-C imposes logistic constraints. We investigated an 18-F ligand, CETO; its 2h half-life permits use in any facility with fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan capability.Objective: To compare the detection of aldosterone-producing ade...

Primary aldosteronism (PA) is considered the sole, often curable, cause of hypertension in 5–10% of patients. Yet there has been only one RCT, and practice has changed little since the advent of CT scanning. Adrenal vein sampling (AVS) and adrenalectomy remain the standard, invasive interventions, leading to a 50% reduction in pill count as the average clinical improvement.Study DesignIn MATCH (Is Metomidate PET-CT superior t...

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...