Endocrine Abstracts

Introduction: Primary aldosteronism (PA) is a common cause of secondary hypertension that can lead to renal sequelae. Treatment of hyperaldosteronism leads to reductions in albuminuria and glomerular hyperfiltration. We aimed to evaluate the effect of treatment on albuminuria and temporal changes in renal function after treatment with both surgery and medications.Methods: We prospectively recruited patients with PA over three years. Spot urine samples fo...

Introduction: Although the Endocrine Society guidelines recommend using aldosterone: renin ratio (ARR) to screen patients for primary aldosteronism (PA), whether to include a cut-off for aldosterone levels remains controversial. In Singapore, most centres require both an ARR >550 (ng/dl)/(ng/ml per h) and aldosterone ≥15 ng/dl. However, it has been shown that patients with PA may have aldosterone levels<15 ng/dl, and also respond well to mineralocorticoid antagon...

Introduction: Low testosterone levels are found in up to 50% of male patients with chronic obstructive pulmonary disease (COPD), and acute illness is associated with further suppression of the central and peripheral gonadal axis. Testosterone supplementation in chronic stable COPD patients has yielded mixed results, demonstrating increased lean body mass, and improved exercise capacity in some studies, but not others. Use of anabolic steroids during acute illness has shown ben...

Background: Patients with an elevated aldosterone renin ratio (ARR) should proceed for a confirmatory test to diagnose primary aldosteronism (PA) before undergoing further investigations such as CT imaging and adrenal venous sampling. The recent 2016 clinical guidelines have included a new recommendation: that in the setting of spontaneous hypokalaemia, undetectable plasma renin, and plasma aldosterone concentration (PAC) >20 ng/dl, patients may not require further confirm...

Introduction: Patients with unilateral primary aldosteronism (PA) can be cured with adrenalectomy, and adrenal vein sampling (AVS) remains the gold-standard test. However, AVS is invasive, technically-challenging and criteria for determining lateralization differ between centres. 11C-Metomidate PET/CT (MTO) imaging offers a promising non-invasive alternative for identifying unilateral PA.Methods: All patients with confirmed primary aldosteronism who were...

Recent studies have reported a high prevalence of USP8 mutations in corticotroph adenomas causing Cushing’s disease. Nelson’s syndrome is a potentially life-threatening complication of bilateral adrenalectomy in patients with refractory Cushing’s disease that is caused by the development of an ACTH-secreting tumor in the pituitary gland. Whether USP8 alterations are also present in Nelson’s tumors has not been studied in detail so far....