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Horm Metab Res 2020; 52(06): 373-378
DOI: 10.1055/a-1141-3526
Review

Developments in Primary Aldosteronism Subtyping Using Steroid Profiling

Taweesak Wannachalee 
1   Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA
2   Division of Endocrinology and Metabolism, Siriraj Hospital, Mahidol University, Bangkok, Thailand
,
Adina F. Turcu 
1   Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA
› Author Affiliations Funding: AFT was supported by grants1K08DK109116 from the NIDDK and 2019087 from the Doris Duke Charitable Foundation.
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Abstract

Adrenal venous sampling is the standard of care for identifying patients with unilateral primary aldosteronism, which is often caused by an aldosterone producing adenoma and can be cured with surgery. The numerous limitations of adrenal venous sampling, including its high cost, scarce availability, technical challenges, and lack of standardized protocols, have driven efforts to develop alternative, non-invasive tools for the diagnosis of aldosterone producing adenomas. Seminal discoveries regarding the pathogenesis of aldosterone producing adenomas made over the past decade have leveraged hypotheses-driven research of steroid phenotypes characteristic of various aldosterone producing adenomas. In parallel, the expanding availability of mass spectrometry has enabled the simultaneous quantitation of many steroids in single assays from small volume biosamples. Steroid profiling has contributed to our evolving understanding about the pathophysiology of primary aldosteronism and its subtypes. Herein, we review the current state of knowledge regarding the application of multi-steroid panels in assisting with primary aldosteronism subtyping.

Key words

primary aldosteronism - adrenal vein sampling - steroids - adrenal - aldosterone


Publication History

Received: 28 December 2019

Accepted: 09 March 2020

Article published online:
24 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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