1/2. Primary aldosteronism due to unilateral adrenal hyperplasia.A 45-yr-old man with hypertension, hypokalemia, low plasma renin, and hyperaldosteronism was studied. plasma and urine aldosterone were consistently above normal, remaining abnormally high even on a 300-meq sodium intake. plasma aldosterone had a marked circadian rhythm, which was correlated with plasma cortisol. aldosterone secretion was temporarily suppressed after dexamethasone administration and was stimulated by exogenous ACTH. The effect of posture was variable in the eight studies performed, possible due to episodic secretion of aldosterone observed near the sampling times of 0800 and 1200 h. Blood from the right adrenal vein contained 50--100 times more aldosterone than the left adrenal venous samples. The right adrenal gland was excised and found to contain many microscopic subcapsular nests of clear cells. plasma aldosterone, renin, and potassium returned to normal after surgery, and blood pressure fell to 120/75 over the next 8 months. Three years later, the patient is normotensive without drugs.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/2. Antenatal diagnosis of congenital adrenal hyperplasia.The concentration of 17-OH-progesterone (17-OHP) was measured retrospectively in a second-trimester amniotic-fluid sample obtained from a mother who had an infant with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The concentration was more than three times the mean amniotic-fluid-17OHP concentration determined in pregnancies of comparable gestational age with normal outcome. In four further pregnancies tested, where the parents were heterozygous for CAH, amniotic-fluid concentrations of 17-OHP were normal. To date, three of the mothers have delivered normal infants. CAH can be detected in early pregnancy by specific radioimmunoassay techniques for steroid-hormone analysis in amniotic fluid. This antenatal test could be useful in those cases in which parents do not wish to risk having affected offspring.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |