| Full text | |
| Author(s): Show less - |
Vilela, Leticia A. P.
[1]
;
Rassi-Cruz, Marcela
[1]
;
Guimaraes, Augusto G.
[1]
;
Moises, Caio C. S.
[1]
;
Freitas, Thais C.
[1]
;
Alencar, Natalia P.
[1]
;
Petenuci, Janaina
[1]
;
Goldbaum, Tatiana S.
[1]
;
Maciel, Ana Alice W.
[1]
;
Pereira, Maria Adelaide A.
[1]
;
Silva, V, Giovanio
;
Pio-Abreu, Andrea
[2]
;
Zerbini, Maria Claudia N.
[3]
;
Cavalcante, Aline C. B. S.
[4]
;
Carnevale, Francisco C.
[4]
;
Pilan, Bruna
[4]
;
Yamauchi, Fernando
[4]
;
Srougi, Vitor
[5]
;
Tanno, Fabio Y.
[5]
;
Chambo, Jose L.
[5]
;
Latronico, Ana Claudia
[1]
;
Mendonca, Berenice B.
[1]
;
Fragoso, V, Maria Candida B.
;
Bortolotto, Luiz A.
[6]
;
Drager, Luciano F.
[6, 2]
;
Almeida, Madson Q.
[7, 8]
Total Authors: 26
|
| Affiliation: | [1] Univ Sao Paulo, Serv Endocrinol & Metabol, Lab Hormonios & Genet Mol LIM 42, Unidade Suprarrenal, Hosp Clin, Fac Med, BR-05403900 Sao Paulo - Brazil
[2] Silva, Giovanio, V, Univ Sao Paulo, Hosp Clin, Unidade Hipertensao Disciplina Nefrol, Fac Med, BR-01246000 Sao Paulo - Brazil
[3] Univ Sao Paulo, Fac Med, Div Anat Patol, BR-05403900 Sao Paulo - Brazil
[4] Univ Sao Paulo, Hosp Clin, Inst Radiol InRad, Fac Med, BR-05402000 Sao Paulo - Brazil
[5] Univ Sao Paulo, Hosp Clin, Fac Med, Servi Urol, BR-05402000 Sao Paulo - Brazil
[6] Univ Sao Paulo, Inst Cora InCor, Fac Med, Unidade Hipertensao, BR-05402000 Sao Paulo - Brazil
[7] Fragoso, Maria Candida B., V, Univ Sao Paulo, Serv Endocrinol & Metabol, Lab Hormonios & Genet Mol LIM 42, Unidade Suprarrenal, Hosp Clin, Fac Med, BR-05403900 Sao Paulo - Brazil
[8] Fragoso, Maria Candida B., V, Univ Sao Paulo, ICESP, Serv Endocrinol, Fac Med, BR-05403010 Sao Paulo - Brazil
Total Affiliations: 8
|
| Document type: | Journal article |
| Source: | JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM; v. 104, n. 10, p. 4695-4702, OCT 2019. |
| Web of Science Citations: | 0 |
| Abstract | |
Context: Primary aldosteronism (PA) is the most common cause of endocrine hypertension (HT). HT remission (defined as blood pressure <140/90 mm Hg without antihypertensive drugs) has been reported in approximately 50% of patients with unilateral PA after adrenalectomy. HT duration and severity are predictors of blood pressure response, but the prognostic role of somatic KCNJ5 mutations is unclear. Objective: To determine clinical and molecular features associated with HT remission after adrenalectomy in patients with unilateral PA. Methods: We retrospectively evaluated 100 patients with PA (60 women; median age at diagnosis 48 years with a median follow-up of 26 months). Anatomopathological analysis revealed 90 aldosterone-producing adenomas, 1 carcinoma, and 9 unilateral adrenal hyperplasias. All patients had biochemical cure after unilateral adrenalectomy. KCNJ5 gene was sequenced in 76 cases. Results: KCNJ5 mutations were identified in 33 of 76 (43.4%) tumors: p.Gly151Arg (n = 17), p.Leu168Arg (n = 15), and p.GIu145GIn (n = 1). HT remission was reported in 37 of 100 (37%) patients. Among patients with HT remission, 73% were women (P = 0.04), 48.6% used more than three antihypertensive medications (P= 0.0001), and 64.9% had HT duration <10 years (P= 0.0015) compared with those without HT remission. Somatic KCNJ5 mutations were associated with female sex (P = 0.004), larger nodules (P = 0.001), and HT remission (P = 0.0001). In multivariate analysis, only a somatic KCNJ5 mutation was an independent predictor of HT remission after adrenalectomy (P = 0.004). Conclusion: The presence of a KCNJ5 somatic mutation is an independent predictor of HT remission after unilateral adrenalectomy in patients with unilateral PA. (AU) | |
| FAPESP's process: | 15/17049-8 - Genetic investigation of aldosterone-producing adrenocortical tumors by next generation sequencing |
| Grantee: | Madson Queiroz Almeida |
| Support Opportunities: | Regular Research Grants |