The unique steroidogenesis of the aldosteronoma in the differential diagnosis of primary aldosteronism

The Journal of Clinical Endocrinology and Metabolism
S UlickE D Vaughan

Abstract

18-Hydroxycortisol and 18-oxocortisol have been isolated from the urine of patients with aldosterone producing adrenocortical adenomas, but not from those with idiopathic hyperaldosteronism associated with bilateral adrenal hyperplasia. These C-18 oxygenated cortisols are biosynthesized by the substitution of cortisol for the normal substrate, corticosterone, in the terminal oxidase system required for the biosynthesis of 18-hydroxycorticosterone and aldosterone. To make use of this biochemical difference between the two groups in the preoperative diagnosis of primary aldosteronism, we have developed and utilized a specific primary standard analytical method, stable isotope dilution mass fragmentography, for quantifying 18-hydroxycortisol and the tetrahydro metabolite of 18-oxocortisol in 24-h urine samples. The normal range by this technique of 4.6 +/- 1.8 micrograms/day tetrahydro 18-oxocortisol and 43 +/- 23 micrograms/day 18-hydroxycortisol in urine was lower and narrower than previous estimates using other methods. Excretion of the 18-oxocortisol metabolite ranged from 2-12 micrograms/day in bilateral hyperplasia and 17-1203 micrograms/day in typical adenomas. 18-Hydroxycortisol excretion similarly separated bilateral hype...Continue Reading

Citations

Apr 6, 2004·Molecular and Cellular Endocrinology·Jérôme NicodPaolo Ferrari
Oct 1, 1996·Disease-a-month : DM·B E AkpunonuE A Hoffman
May 14, 2011·Endocrinology and Metabolism Clinics of North America·Florencia Halperin, Robert G Dluhy
Dec 1, 2007·American Journal of Hypertension·Francesca PizzoloOliviero Olivieri
Oct 17, 2002·Annals of the New York Academy of Sciences·Richard V JacksonConstantine Stratakis
Sep 27, 2000·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·D J TorpyG P Chrousos
Dec 21, 2018·Hypertension·Yuki SugiuraKoshiro Nishimoto
Sep 15, 2017·European Journal of Endocrinology·Jacques W M LendersCelso E Gomez-Sanchez
Apr 21, 1999·Clinical Endocrinology·G P RossiA C Pessina

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