Thirty female and male essential hypertensive patients and eighteen normotensive controls were submitted to the TRH-TSH conventional test (200 ug intravenously, bolus injection of TRH). Supramaximal doses of 400 and 600 ug were repeated with a week interval to each subject. Hypertensives showed a significant lower response to both conventional and supramaximal TRH doses. Hypothalamic-pituitary-thyroid axis abnormalities, secondary to TRH-receptor alterations, could account for this result.
Objectives: Primary aldosteronism (PA) is characterized by the autonomous overproduction of aldosterone. Its prevalence has increased since the use of the aldosterone (ALD)/plasma renin activity (PRA) ratio (ARR). The objective of this study is to determine ARR and ARC (ALD/plasma renin concentration ratio) cut-off values (COV) and their diagnostic concordance (DC%) in the screening for PA in an Argentinian population. Design: multicenter prospective study. Subjects and methods: We studied 353 subjects (104 controls and 249 hypertensive patients). Serum aldosterone, PRA and ARR were determined. In 220 randomly selected subjects, 160 hypertensive patients and 60 controls, plasma renin concentration (PRC) was simultaneously measured and ARC was determined. Results: According to the 95 th percentile of controls, we determined a COV of 36 for ARR and 2.39 for ARC, with ALD ≥ 15 ng/dL. In 31/249 hypertensive patients, ARR was ≥ 36. PA diagnosis was established in 8/31 patients (23/31 patients did not complete confirmatory tests). DC% between ARR and ARC was calculated. A significant correlation between ARR and ARC (r = 0.742; p < 0.0001) was found only with PRA > 0.3 ng/mL/h and PRC > 5 pg/mL. DC% for ARR and ARC above or below 36 and 2.39 was 79.1%, respectively. Conclusion: This first Argentinian multicenter study determined a COV of 36 for ARR and 2.39 for ARC. Applying an ARR ≥ 36 in the hypertensive group, we confirmed PA in a higher percentage of patients than the previously reported one in our population. As for ARC, further studies are needed for its clinical application, since DC% is acceptable only for medium range renin values. Arch Endocrinol Metab. 2015;59(5):441-7
In Argentina, data regarding Pheochromocytomas and Paragangliomas (PPGLs) are scarse.Objective:to describe demographic, biochemical and genetic characteristics of children and adults with confirmed PPGls.Design and method:Observational multicenter study of recruited participants surveyed from a retrospective cross sectional database from january 1953 until January 2022.Results:We included 486 patients (58.4% women) from 93 recruiting centers, mean age at diagnosis 38.3, 393 (80.9%) hypertensives, baseline office systolic/diastolic blood pressure 157.8/96.5 mmHg. Of all tumors, 382 (79.6%) were Pheochromocytomas, 67 (13.8%) paragangliomas and 11 (2.3%) mixed. The most prevalent cathecolamin secretion type was noradrenergic (35%), followed by adrenergic (30.6%) and mixed (20.3%). Local recurrence and mestastasis occured in 10% of subjects. The most common symptoms were headache (57%), sweating (57.5%) and palpitations (53.4%). In 147 patients with a genetic syndrome, we found 44 MEN2A, 7 MEN2B, 1 MEN1, 42 Von Hippel Lindau, 11 neurofibromatosis type 1, 32 PGL4, 6 PGL1, 2 MAX, 1 TMEM127, and 1 mosaic EPAS1/HIF2A. We found the genetic variant types in 102 patients.Conclusions:Our results are consistent with other publications from foreign databases. PPGls are rarely diagnosed in Argentina, and the genetic profile is lacking in three fourths of patients.
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