Hypoaldosteronism diagnostic criteria: Difference between revisions
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==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
*There is no established [[criteria]] for the [[diagnosis]] of hypoaldosteronism. However, a positive history of [[hypotension]], [[muscle weakness]] and [[fatigue]] should raise suspicion for hypoaldosteronism. | *There is no established [[criteria]] for the [[diagnosis]] of hypoaldosteronism. However, a positive history of [[hypotension]], [[muscle weakness]] and [[fatigue]] should raise suspicion for hypoaldosteronism.<ref name="pmid9300202">{{cite journal |vauthors=White PC |title=Abnormalities of aldosterone synthesis and action in children |journal=Curr. Opin. Pediatr. |volume=9 |issue=4 |pages=424–30 |year=1997 |pmid=9300202 |doi= |url=}}</ref><ref name="pmid10559665">{{cite journal |vauthors=Peter M, Dubuis JM, Sippell WG |title=Disorders of the aldosterone synthase and steroid 11beta-hydroxylase deficiencies |journal=Horm. Res. |volume=51 |issue=5 |pages=211–22 |year=1999 |pmid=10559665 |doi=23374 |url=}}</ref><ref name="pmid16024935">{{cite journal |vauthors=Kuribayashi I, Nomoto S, Massa G, Oostdijk W, Wit JM, Wolffenbuttel BH, Shizuta Y, Honke K |title=Steroid 11-beta-hydroxylase deficiency caused by compound heterozygosity for a novel mutation, p.G314R, in one CYP11B1 allele, and a chimeric CYP11B2/CYP11B1 in the other allele |journal=Horm. Res. |volume=63 |issue=6 |pages=284–93 |year=2005 |pmid=16024935 |doi=10.1159/000087074 |url=}}</ref> | ||
**In these patients [[Plasma renin activity|plasma renin activity (PRA)]], serum [[aldosterone]], and serum [[cortisol]] should be measured. | **In these patients [[Plasma renin activity|plasma renin activity (PRA)]], serum [[aldosterone]], and serum [[cortisol]] should be measured. | ||
**Patients with suspected hypoaldosteronism should be also be tested for underlying conditions which can lead to decreased [[aldosterone]] level or aldosterone resistance such as [[diabetes]], [[chronic kidney disease]], [[Mineralocorticoid|serum mineralocorticoid]], [[corticosteroid]] and [[androgen]] level. | **Patients with suspected hypoaldosteronism should be also be tested for underlying conditions which can lead to decreased [[aldosterone]] level or aldosterone resistance such as [[diabetes]], [[chronic kidney disease]], [[Mineralocorticoid|serum mineralocorticoid]], [[corticosteroid]] and [[androgen]] level. | ||
**Patients with [[family history]] of hypoaldosteronism should be checked for [[CYP11B2]] ([[aldosterone synthase]]) and NR3C2 ([[mineralocorticoid receptor]]) [[gene]] [[mutations]]. | **Patients with [[family history]] of hypoaldosteronism should be checked for [[CYP11B2]] ([[aldosterone synthase]]) and NR3C2 ([[mineralocorticoid receptor]]) [[gene]] [[mutations]]. | ||
*Complete history should also be obtained regarding [[drug]] use which can affect [[Aldosterone antagonist|aldosterone]] [[synthesis]] or [[Function (biology)|function]] such as [[NSAIDs|NSAID]], [[Angiotensin-converting enzyme|ACEi]], [[Beta blockers|B blockers]], [[heparin]], [[Calcineurin inhibitor|calcineurin inhibitors]]. | *Complete history should also be obtained regarding [[drug]] use which can affect [[Aldosterone antagonist|aldosterone]] [[synthesis]] or [[Function (biology)|function]] such as [[NSAIDs|NSAID]], [[Angiotensin-converting enzyme|ACEi]], [[Beta blockers|B blockers]], [[heparin]], [[Calcineurin inhibitor|calcineurin inhibitors]]. | ||
*Asymptomatic hypoaldosteronism can also be discovered during routine [[laboratory]] evaluations. | *Asymptomatic hypoaldosteronism can also be discovered during routine [[laboratory]] evaluations. | ||
==References== | ==References== | ||
Revision as of 14:34, 1 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
There is no established criteria for the diagnosis of hypoaldosteronism. However, a positive history of hypotension, muscle weakness and fatigue should raise suspicion for hypoaldosteronism. These patients should first be tested for serum potassium levels and later for plasma renin activity (PRA), serum aldosterone, and serum cortisol. Asymptomatic hypoaldosteronism can also be discovered on routine laboratory evaluations.
Diagnostic Criteria
- There is no established criteria for the diagnosis of hypoaldosteronism. However, a positive history of hypotension, muscle weakness and fatigue should raise suspicion for hypoaldosteronism.[1][2][3]
- In these patients plasma renin activity (PRA), serum aldosterone, and serum cortisol should be measured.
- Patients with suspected hypoaldosteronism should be also be tested for underlying conditions which can lead to decreased aldosterone level or aldosterone resistance such as diabetes, chronic kidney disease, serum mineralocorticoid, corticosteroid and androgen level.
- Patients with family history of hypoaldosteronism should be checked for CYP11B2 (aldosterone synthase) and NR3C2 (mineralocorticoid receptor) gene mutations.
- Complete history should also be obtained regarding drug use which can affect aldosterone synthesis or function such as NSAID, ACEi, B blockers, heparin, calcineurin inhibitors.
- Asymptomatic hypoaldosteronism can also be discovered during routine laboratory evaluations.
References
- ↑ White PC (1997). "Abnormalities of aldosterone synthesis and action in children". Curr. Opin. Pediatr. 9 (4): 424–30. PMID 9300202.
- ↑ Peter M, Dubuis JM, Sippell WG (1999). "Disorders of the aldosterone synthase and steroid 11beta-hydroxylase deficiencies". Horm. Res. 51 (5): 211–22. doi:23374 Check
|doi=value (help). PMID 10559665. - ↑ Kuribayashi I, Nomoto S, Massa G, Oostdijk W, Wit JM, Wolffenbuttel BH, Shizuta Y, Honke K (2005). "Steroid 11-beta-hydroxylase deficiency caused by compound heterozygosity for a novel mutation, p.G314R, in one CYP11B1 allele, and a chimeric CYP11B2/CYP11B1 in the other allele". Horm. Res. 63 (6): 284–93. doi:10.1159/000087074. PMID 16024935.