A Rare Presentation of Primary Hyperparathyroidism with Concurrent Aldosterone-Producing Adrenal Carcinoma

Molina-Ayala, Mario; Ramírez‐Rentería, Claudia; Manguilar-León, Analleli; Paúl-Gaytán, Pedro; Ferreira‐Hermosillo, Aldo

doi:10.1155/2015/910984

Cited by 5 publications

(4 citation statements)

References 22 publications

(26 reference statements)

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“…Les adénomes de Conn sont souvent inférieurs à 5cm, tandis que les carcinomes sont souvent plus larges [ 3 ]. A notre connaissance, 64 cas de CS entrainant un HAP ont été rapportés [ 7 , 9 , 11 - 15 ]. Seccia TM et al ont fait une revue de 58 cas de CS produisant l'aldostérone [ 2 ].…”

Section: Discussionunclassified

Le corticosurrénalome: une cause exceptionnelle d’hyperaldostéronisme primaire

Zantour¹,

Charrada²,

Elati³

et al. 2018

Pan Afr Med J

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Le corticosurrénalome est une tumeur maligne rare de la cortico-surrénale. Il secrète souvent des corticostéroïdes, des stéroïdes sexuels et des précurseurs. Le corticosurrénalome producteur d'aldostérone est très rare, 1cas/10 millions d'habitants. Nous rapportons l'observation d'un homme de 38 ans se présentant pour hypertension artérielle sévère associée à une hypokaliémie profonde (2.2 mmol/l). L'exploration a conclu à un hyperaldostéronisme primaire (aldostérone = 2645pmol/l, rapport aldostérone/rénine = 327pmol/mUI), avec hypersécrétion de glucocorticoïdes. Le scanner abdomino-pelvien a montré une masse surrénalienne gauche de 9cm, mal limitée et hétérogène, infiltrant la graisse autour et le diaphragme, envahissant la veine rénale gauche, avec adénopathie régionale et nodule hépatique de 4 cm. Le patient a eu une néphrectomie élargie, suivie d'une hépatectomie droite deux mois après entrainant une rémission. Un an après le patient a développé des métastases pulmonaires. Nous concluons que l'hyperaldostéronisme primaire peut être un mode de révélation du corticosurrénalome, on devra y penser malgré son caractère exceptionnel.

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Section: Discussionunclassified

Le corticosurrénalome: une cause exceptionnelle d’hyperaldostéronisme primaire

Zantour¹,

Charrada²,

Elati³

et al. 2018

Pan Afr Med J

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“…The two main causes of the disease are unilateral aldosterone producing adenomas and bilateral hyperplasia (sporadic and familial cases). Furthermore, there are less common forms of hyperaldosteronism such as unilateral adrenal hyperplasia, aldosterone-producing adrenocortical carcinomas and ectopic aldosterone-secreting tumors [12][13][14]. In PA, the high aldosterone concentrations are accompanied by inadequately low renin, because renin secretion is suppressed as a consequence of the negative feedback loop.…”

Section: Physiology Behind the Arrmentioning

confidence: 99%

Aldosterone to Renin Ratio as Screening Tool in Primary Aldosteronism

Schilbach

Junnila

Bidlingmaier

2018

Exp Clin Endocrinol Diabetes

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Primary aldosteronism (PA) is a severe and often underdiagnosed form of secondary hypertension. Determining the aldosterone to renin ratio (ARR) in hypertensive patients has been shown to be a valuable screening test for identification of patients suffering from PA. Since the introduction of a more widespread ARR screening the number of PA patients significantly increased worldwide. Interpretation of ARR might be challenging: Several factors from posture to interfering drugs affect the ARR and need to be taken into account when collecting samples. In addition, the wide variety of available assay methods and lack of well-established cut-offs present a challenge to the clinician. This review discusses the usefulness and possible difficulties of ARR screening.

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“…In 1980, first case reports about coincident PA and pHPT were published [85,86]. Recently, there are more and more reports about coincident PA and pHPT [87][88][89]. The first such patient was reported by Maniero et al [68].…”

Section: Pathophysiological Mechanisms Linking Aldosterone and Pth Sementioning

confidence: 99%

Parathyroid Gland Function in Primary Aldosteronism

2015

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Primary aldosteronism (PA) is the most frequent cause of secondary arterial hypertension. Beyond its effects on intravascular volume and blood pressure, PA causes metabolic alterations and a higher cardiovascular morbidity, which is reduced by PA-directed therapy. Experimental studies demonstrated that mineralocorticoid excess may also influence mineral homeostasis. A role in cardiovascular disease has also been attributed to parathyroid hormone (PTH). Increasing evidence supports a bidirectional interaction between aldosterone and PTH.Primary hyperparathyroidism is associated with arterial hypertension and an increased cardiovascular morbidity and mortality, which might be associated to higher aldosterone values; parathyreoidectomy results in lowered aldosterone and blood pressure levels. PA leads to secondary hyperparathyroidism, which is reversible by PA-directed therapy. A lower bone mineral density and a higher fracture rate were also shown to be reversible by PA-directed therapy. There is a suspicion of a bidirectional interaction between aldosterone and PTH, which might lead to a higher cardiovascular risk. There are more and more reports about coincident PA and primary hyperparathyroidism. From a pathophysiologic point of view this constellation is best characterized as tertiary hyperparathyroidism. Future aspects should further clarify the extent of these endocrine interactions and analyze the influence of this interplay on cardiovascular morbidity and mortality and bone health.

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A Rare Presentation of Primary Hyperparathyroidism with Concurrent Aldosterone-Producing Adrenal Carcinoma

Cited by 5 publications

References 22 publications

Le corticosurrénalome: une cause exceptionnelle d’hyperaldostéronisme primaire

Le corticosurrénalome: une cause exceptionnelle d’hyperaldostéronisme primaire

Aldosterone to Renin Ratio as Screening Tool in Primary Aldosteronism

Parathyroid Gland Function in Primary Aldosteronism

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