17-ketosteroids and Hyperaldosteronism

Topics: 17-Ketosteroids; Addison Disease; Adolescent; Adrenal Glands; Adrenal Insufficiency; Adult; Aldosterone; Androgens; Child; Cushing Syndrome; Dehydroepiandrosterone; Desoxycorticosterone; Dexamethasone; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hypertension; Infant; Male; Pituitary-Adrenal Function Tests; Renin; Spironolactone; Virilism

Topics: 17-Ketosteroids; Adrenal Insufficiency; Adrenocortical Hyperfunction; Adrenogenital Syndrome; Anabolic Agents; Hirsutism; Hyperaldosteronism; Hypertrichosis; Hypogonadism; Metabolism; Steroids; Urine

Topics: 17-Ketosteroids; Acetates; Adenoma; Androgen-Insensitivity Syndrome; Androgens; Androsterone; Carbon Isotopes; Chemistry, Clinical; Chromatography, Paper; Clinical Trials as Topic; Cushing Syndrome; Etiocholanolone; Female; Hirsutism; Humans; Hyperaldosteronism; Male; Methods; Myoma; Puberty, Precocious; Testosterone; Tritium; Uterine Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aldosterone; Body Weight; Clinical Trials as Topic; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypopituitarism; Male; Metyrapone; Middle Aged; Natriuresis; Pituitary-Adrenal System; Potassium; Secretory Rate

A 40 year-old man was admitted to our hospital for detailed examination of hypokalemia (2.7 mEq/l). His blood pressure was normal. Metabolic alkalosis, ACTH dependent hyperaldosteronism (18 ng/dl) and over-response to synthetic ACTH were observed. Plasma renin activity, on the other hand, was within the normal range (1.7 ng/ml/hr). Serum potassium was normalized to 4.1 mEq/l and the responsiveness of the renin-angiotensin-aldosterone system was recovered after the administration of dexamethasone. These results led us to suggest that this case might be normotensive glucocorticoid-suppressible hyperaldosteronism. The etiology which was not associated with hypertension and low plasma renin activity has not been clarified but may be related to the shortness of duration of this disease. Our case was also afflicted with mild hypercortisolemia and excessive excretion of urinary 17-hydroxycorticosteroid and 17-ketosteroid which was suppressed by the administration of dexamethasone (2 mg/day). These findings may be related to hypersensitivity of the fascicular zone of the adrenal gland to ACTH.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Circadian Rhythm; Dexamethasone; Humans; Hydrocortisone; Hyperaldosteronism; Hypokalemia; Male; Renin-Angiotensin System

We describe a direct method for determining four sulfates and seven glucuronides of 17-oxosteroids (17OS) in urine without hydrolysis, by use of "high-performance" liquid chromatography (HPLC) with fluorometric detection. After pretreatment of urine samples with a Sep-Pak C18 cartridge, four 17OS sulfates and seven 17OS glucuronides in the pretreated urine samples were reacted with tetrapentylammonium ions to form ion pairs. Ion-paired 17OS sulfates were extracted with benzene. By adding sodium sulfate to the remaining sample, we could then extract ion-paired 17OS glucuronides with dichloromethane. Each extract was labeled with dansyl-hydrazine in an acetic acid-acetonitrile solution. The labeled steroids were separated by HPLC on a reversed-phase Capcell-Pak C8 (silicon-polymer-coated silica gel modified with octyl groups). We monitored each effluent with a fluorometric detector (330 nmexcitation, 535 nmemission).

Topics: 17-Ketosteroids; Chromatography, High Pressure Liquid; Cushing Syndrome; Dansyl Compounds; Fluorometry; Glucuronates; Humans; Hydrazines; Hydrogen-Ion Concentration; Hyperaldosteronism; Male; Quaternary Ammonium Compounds; Solvents; Sulfates

Adrenocortical carcinoma (ACC) is a rare disorder with an estimated incidence of only 0.023 percent of all malignancies. In most cases, Cushing's syndrome and virilization or feminization due to abnormal steroid production by the tumor rapidly lead to the diagnosis. Occasionally, the tumor produces an excessive amount of mineralocorticoids only and ACC can be revealed by an isolated syndrome of primary aldosteronism. Out of 100 cases of tumoral primary aldosteronism studied from 1977 to 1987, we observed 4 ACC and 96 Conn's adenomas (CONN). When primary aldosteronism was diagnosed, ACC and CONN had same clinical features, although hypokalemia in ACC was more profound: 2.2 +/- 0.76 mmol/l (1.4 to 3.2) compared to 2.9 +/- 0.5 (1.6 to 4.2) in CONN. Mean supine plasma aldosterone levels, plasma renin and aldosterone responses to the upright posture or to serum saline infusion, cortisol at 8 a.m. were not different in patients with ACC from those observed in patients with CONN. 24 hours urinary cortisol excretion and 17-ketosteroids excretion were highly increased in three out four patients with ACC. Clinical, biological and hormonal investigations were therefore not sufficient to diagnose malignant tumoral primary aldosteronism. Systematic computed tomographic scanning allowed to differentiate carcinomas from adenomas on the following criteria: ACC showed enlarged tumor size that was always above 30 mm in diameter, whereas the largest CONN measured 20 mm.ACC appeared as an heterogeneous tumor with the presence of internal calcifications in each case of ACC, that were diagnosed both on ultrasound and CT scan, whereas none of the CONN showed any calcification, using the same screening procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Adult; Aldosterone; Calcinosis; Female; Humans; Hydrocortisone; Hyperaldosteronism; Male; Middle Aged; Posture; Potassium; Renin

A 58-year-old white woman with hypertension and severe hypokalemia was found to have a carcinoma of the left adrenal gland. Plasma renin activity was constantly under the normal limit, while plasma aldosterone levels were pathologically elevated. Plasma cortisol (8:00 a.m.) and excretion rates of urinary free cortisol were within the normal range. After an adrenalectomy, relapsing excessive aldosterone secretion was successfully treated with opDDD (Lysodrene). Ten months after the diagnosis was established, the patient died from a bleeding liver metastasis.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Neoplasms; Aldosterone; Combined Modality Therapy; Female; Humans; Hydrocortisone; Hyperaldosteronism; Middle Aged; Paraneoplastic Endocrine Syndromes; Postoperative Complications; Renin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Aldosterone; Dexamethasone; Glucocorticoids; Humans; Hyperaldosteronism; Male; Middle Aged; Renin

1. Using a newly developed and validated radioassay method, we have measured plasma 11-deoxycorticosterone concentrations in a wide spectrum of human hypertensive states. 2. Patients with essential and renovascular hypertension have normal plasma concentrations of 11-deoxycorticosterone. 3. Elevated concentrations are seen in some patients with primary aldosteronism, Cushing's syndrome, low-renin hypertension, and in adult hypertensive subjects with elevated urinary 17-ketosteroid excretion. 4. An aetiological role for deoxycorticosterone in certain forms of human hypertension appears likely.

Topics: 17-Ketosteroids; Cushing Syndrome; Desoxycorticosterone; Humans; Hyperaldosteronism; Hypertension

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Blood Pressure; Cortisone; Cushing Syndrome; Dexamethasone; Female; Humans; Hyperaldosteronism; Pigmentation Disorders

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adult; Aldosterone; Cushing Syndrome; Estradiol; Estrone; Female; Humans; Hyperaldosteronism; Male; Middle Aged; Phlebography; Radioimmunoassay; Renin; Tritium

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aldosterone; Binding, Competitive; Child; Dexamethasone; Female; Fluorometry; Humans; Hydralazine; Hydrocortisone; Hyperaldosteronism; Male; Methyldopa; Pregnanetriol; Radioimmunoassay; Renin; Spironolactone; Tetrahydrocortisone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Aldosterone; Corticosterone; Desoxycorticosterone; Dexamethasone; Diet; Diet, Sodium-Restricted; Follow-Up Studies; Humans; Hydrocortisone; Hyperaldosteronism; Male; Metyrapone; Pregnanetriol; Renin; Secretory Rate

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Aged; Aldosterone; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Hypertension, Malignant; Hypertension, Renal; Male; Middle Aged; Pheochromocytoma; Potassium; Renin; Sodium; Sweat

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Age Factors; Aldosterone; Diet Therapy; Humans; Hyperaldosteronism; Hypertension; Potassium; Sodium; Spironolactone; Time Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adult; Aged; Androstanes; Circadian Rhythm; Female; Humans; Hydroxysteroids; Hyperaldosteronism; Hypertension; Ketosteroids; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Pregnanes; Propionates; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Humans; Hyperaldosteronism; Hypertension; Potassium

Topics: 17-Ketosteroids; Adrenal Glands; Aldosterone; Germany, East; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renal; Kidney; Mandelic Acids; Renin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adrenalectomy; Adrenocortical Hyperfunction; Aldosterone; Blood Pressure; Female; Humans; Hyperaldosteronism; Hyperplasia; Middle Aged; Potassium; Remission, Spontaneous; Renin; Secretory Rate

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adult; Aged; Aldosterone; Angiotensin II; Animals; Biological Assay; Diagnosis, Differential; Female; Furosemide; Humans; Hyperaldosteronism; Hypertension; Hypokalemia; Male; Middle Aged; Posture; Potassium; Rats; Renin; Saliva; Sodium; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenal Rest Tumor; Adrenocorticotropic Hormone; Aldosterone; Chemistry, Clinical; Child; Desoxycorticosterone; Etiocholanolone; Female; Humans; Hyperaldosteronism; Hyperplasia; Hypertension; Metabolism, Inborn Errors; Mixed Function Oxygenases; Ovarian Neoplasms; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Aged; Carcinoma; Humans; Hyperaldosteronism; Male; Renin

Topics: 17-Ketosteroids; Acetoacetates; Adolescent; Adult; Blood Glucose; Blood Pressure; Creatinine; Electrocardiography; Enzymes; Fasting; Female; Glucose Tolerance Test; Humans; Hydroxybutyrates; Hyperaldosteronism; Ketone Bodies; Liver Function Tests; Male; Middle Aged; Nitrogen; Obesity; Pulse; Radiography, Thoracic; Time Factors; Uric Acid

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Aldosterone; Blood Pressure; Catecholamines; Chlorothiazide; Creatinine; Diagnosis, Differential; Diet; Epinephrine; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renal; Hypokalemia; Infusions, Parenteral; Norepinephrine; Potassium; Renal Artery Obstruction; Renin; Sodium; Vanilmandelic Acid

Topics: 17-Ketosteroids; Aged; Aldosterone; Blood Gas Analysis; Blood Pressure; Carbon Dioxide; Cortisone; Humans; Hydrocortisone; Hyperaldosteronism; Hypertonic Solutions; Kidney Glomerulus; Kidney Tubules; Male; Nephrectomy; Potassium; Sodium; Sodium Chloride; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Alkalosis; Electrolytes; Female; Humans; Hyperaldosteronism; Hypertension; Hypokalemia; Renin; Spironolactone

Topics: 17-Ketosteroids; Adrenal Glands; Aminoglutethimide; Aniline Compounds; Anticonvulsants; Cushing Syndrome; Humans; Hyperaldosteronism; Potassium; Pyridones; Sodium; Spironolactone; Steroids

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenalectomy; Adult; Aldosterone; Blood Pressure; Corticosterone; Desoxycorticosterone; Dexamethasone; Diet; Glucocorticoids; Humans; Hyperaldosteronism; Kidney Function Tests; Male; Middle Aged; Potassium; Secretory Rate; Spironolactone; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenalectomy; Adult; Aldosterone; Androgens; Child; Desoxycorticosterone; Dexamethasone; Diet; Estrogens; Female; Follow-Up Studies; Glucocorticoids; Humans; Hydrocortisone; Hyperaldosteronism; Hypertension; Male; Middle Aged; Potassium; Prednisone; Renin; Secretory Rate; Sodium; Spironolactone

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Aldosterone; Ammonium Chloride; Angiotensin II; Bicarbonates; Body Height; Body Weight; Catecholamines; Child; Chlorides; Diet; Female; Glucose Tolerance Test; Humans; Hyperaldosteronism; Hyperplasia; Juxtaglomerular Apparatus; Kidney Diseases; Kidney Function Tests; Metyrapone; Microscopy, Electron; Muscles; Norepinephrine; Pituitary-Adrenal Function Tests; Potassium; Renin; Serum Albumin; Sodium; Spironolactone; Triamterene; Water-Electrolyte Balance

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Insufficiency; Aminoglutethimide; Aniline Compounds; Anticonvulsants; Cushing Syndrome; Female; Hematoma; Hirsutism; Humans; Hyperaldosteronism; Hypothyroidism; Male; Necrosis; Pyridones

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Addison Disease; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Anorexia Nervosa; Child; Child, Preschool; Chromatography; Cushing Syndrome; Disorders of Sex Development; Endocrine System Diseases; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hyperthyroidism; Hypertrichosis; Hypopituitarism; Male; Middle Aged; Myxedema; Obesity; Pheochromocytoma; Pregnancy; Spectrophotometry

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Diagnosis, Differential; Glucocorticoids; Humans; Hyperaldosteronism; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Adult; Desoxycorticosterone; Female; Humans; Hyperaldosteronism; Natriuresis; Phenethylamines; Potassium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenalectomy; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Renin

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Intestinal Polyps; Male; Pheochromocytoma

A father and son are described with a condition characterized by benign hypertension, potassium deficiency, increased aldosterone secretion rate (ASR), raised plasma volume and suppressed plasma renin activity (PRA). There were intermittent elevations of urine 17-ketosteroids and 17-hydroxycorticoids (17-OHCS) but no increase in urine THS, normal circadian rhythm of plasma 17-OHCS, and normal urine 17-OHCS response to dexamethasone and intravenous ACTH. Plasma ACTH and corticosterone secretion were not elevated. Pregnanetriol excretion was normal but urine pregnanediol was increased. At operation on the father no adrenal tumour was found; the excised left adrenal weighed 7 g. and showed nodular cortical hyperplasia; juxtaglomerular cells showed only occasional granules. Following operation hypertension persisted and ASR was half the preoperative value. All abnormalities in father and son were relieved by dexamethasone (DM) 2 mg. daily. The condition recurred following cessation of DM but was relieved by a second course of treatment. No such response to DM was seen in a normal subject or in a patient with Conn's syndrome. For a number of reasons it is suggested that patients with hypertension, increased ASR and low PRA be given a trial of dexamethasone treatment before undergoing adrenal surgery.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Dexamethasone; Diagnosis, Differential; Female; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Potassium Deficiency; Renin

Topics: 17-Ketosteroids; Acidosis; Adrenal Gland Neoplasms; Adult; Blood Glucose; Diabetes Mellitus; Female; Glucose; Glucose Tolerance Test; Humans; Hyperaldosteronism; Hypoglycemia; Male; Middle Aged; Tromethamine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Alkalosis; Child; Dwarfism; Female; Humans; Hyperaldosteronism; Hyperkalemia; Hyperplasia; Juxtaglomerular Apparatus; Photometry

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adult; Breast Neoplasms; Child, Preschool; Cortisone; Cushing Syndrome; Disorders of Sex Development; Female; Humans; Hyperaldosteronism; Infant; Male; Pheochromocytoma; Prednisolone; Virilism

Topics: 17-Ketosteroids; Addison Disease; Adrenal Glands; Adrenocorticotropic Hormone; Adrenogenital Syndrome; Asthma; Carcinoma, Bronchogenic; Coccidioidomycosis; Cushing Syndrome; Diabetes Mellitus; Ethinyl Estradiol; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hypopituitarism; Hypotension; Myocardial Infarction; Neurotic Disorders; Pituitary Neoplasms; Polycystic Ovary Syndrome

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocortical Hyperfunction; Adrenogenital Syndrome; Cushing Syndrome; Humans; Hyperaldosteronism; Pheochromocytoma

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocortical Adenoma; Child; Humans; Hyperaldosteronism; Hypernatremia; Hypertension; Hypertrichosis; Hypokalemia; Potassium; Sodium; Spironolactone; Urine

Topics: 17-Ketosteroids; Adrenalectomy; Aldosterone; Biomedical Research; Body Fluids; Corticosterone; Dexamethasone; Drug Therapy; Electrolytes; Fluids and Secretions; Hyperaldosteronism; Ketones; Metabolism; Mineralocorticoid Receptor Antagonists; Natriuresis; Oxidation-Reduction; Potassium; Pyridines; Urine

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Glands; Aldosterone; Angiography; Blood; Catheterization; Chlorides; Contrast Media; Humans; Hydrocortisone; Hyperaldosteronism; Kidney Function Tests; Phlebography; Potassium; Spironolactone; Surgical Procedures, Operative; Veins

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Chlorides; Creatine; Creatinine; Electrolytes; Humans; Hyperaldosteronism; Natriuresis; Pharmacology; Postoperative Care; Potassium; Spironolactone; Urine

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Hormones; Aldosterone; Glucocorticoids; Humans; Hyperaldosteronism