Search Results
Search for other papers by Cristina Lamas in
Google Scholar
PubMed
Search for other papers by Elena Navarro in
Google Scholar
PubMed
Search for other papers by Anna Casterás in
Google Scholar
PubMed
Search for other papers by Paloma Portillo in
Google Scholar
PubMed
Search for other papers by Victoria Alcázar in
Google Scholar
PubMed
Search for other papers by María Calatayud in
Google Scholar
PubMed
Search for other papers by Cristina Álvarez-Escolá in
Google Scholar
PubMed
Search for other papers by Julia Sastre in
Google Scholar
PubMed
Search for other papers by Evangelina Boix in
Google Scholar
PubMed
Search for other papers by Lluis Forga in
Google Scholar
PubMed
Search for other papers by Almudena Vicente in
Google Scholar
PubMed
Search for other papers by Josep Oriola in
Google Scholar
PubMed
Search for other papers by Jordi Mesa in
Google Scholar
PubMed
Search for other papers by Nuria Valdés in
Google Scholar
PubMed
Primary hyperparathyroidism is the most frequent manifestation of multiple endocrine neoplasia type 1 (MEN1) syndrome. Bone and renal complications are common. Surgery is the treatment of choice, but the best timing for surgery is controversial and predictors of persistence and recurrence are not well known. Our study describes the clinical characteristics and the surgical outcomes, after surgery and in the long term, of the patients with MEN1 and primary hyperparathyroidism included in the Spanish Registry of Multiple Endocrine Neoplasia, Pheochromocytomas and Paragangliomas (REGMEN). Eighty-nine patients (49 men and 40 women, 34.2 ± 13 years old) were included. Sixty-four out of the 89 underwent surgery: a total parathyroidectomy was done in 13 patients, a subtotal parathyroidectomy in 34 and a less than subtotal parathyroidectomy in 15. Remission rates were higher after a total or a subtotal parathyroidectomy than after a less than subtotal (3/4 and 20/22 vs 7/12, P < 0.05), without significant differences in permanent hypoparathyroidism (1/5, 9/23 and 0/11, N.S.). After a median follow-up of 111 months, 20 of the 41 operated patients with long-term follow-up had persistent or recurrent hyperparathyroidism. We did not find differences in disease-free survival rates between different techniques, patients with or without permanent hypoparathyroidism and patients with different mutated exons, but a second surgery was more frequent after a less than subtotal parathyroidectomy.
University of Alcalá, Madrid, Spain
Search for other papers by Marta Araujo-Castro in
Google Scholar
PubMed
Search for other papers by Miguel Paja Fano in
Google Scholar
PubMed
Search for other papers by Begoña Pla Peris in
Google Scholar
PubMed
Search for other papers by Marga González Boillos in
Google Scholar
PubMed
Search for other papers by Eider Pascual-Corrales in
Google Scholar
PubMed
Search for other papers by Ana María García-Cano in
Google Scholar
PubMed
Search for other papers by Paola Parra Ramírez in
Google Scholar
PubMed
Search for other papers by Patricia Martín Rojas-Marcos in
Google Scholar
PubMed
Search for other papers by Jorge Gabriel Ruiz-Sanchez in
Google Scholar
PubMed
Search for other papers by Almudena Vicente in
Google Scholar
PubMed
Search for other papers by Emilia Gómez-Hoyos in
Google Scholar
PubMed
Search for other papers by Rui Ferreira in
Google Scholar
PubMed
Search for other papers by Iñigo García Sanz in
Google Scholar
PubMed
Search for other papers by Mónica Recasens in
Google Scholar
PubMed
Search for other papers by Rebeca Barahona San Millan in
Google Scholar
PubMed
Search for other papers by María José Picón César in
Google Scholar
PubMed
Search for other papers by Patricia Díaz Guardiola in
Google Scholar
PubMed
Search for other papers by Carolina Perdomo in
Google Scholar
PubMed
Search for other papers by Laura Manjón in
Google Scholar
PubMed
Search for other papers by Rogelio García-Centeno in
Google Scholar
PubMed
Search for other papers by Juan Carlos Percovich in
Google Scholar
PubMed
Search for other papers by Ángel Rebollo Román in
Google Scholar
PubMed
Search for other papers by Paola Gracia Gimeno in
Google Scholar
PubMed
Search for other papers by Cristina Robles Lázaro in
Google Scholar
PubMed
Search for other papers by Manuel Morales in
Google Scholar
PubMed
Search for other papers by María Calatayud in
Google Scholar
PubMed
Search for other papers by Simone Andree Furio Collao in
Google Scholar
PubMed
Search for other papers by Diego Meneses in
Google Scholar
PubMed
Search for other papers by Miguel Antonio Sampedro Nuñez in
Google Scholar
PubMed
Search for other papers by Verónica Escudero Quesada in
Google Scholar
PubMed
Search for other papers by Elena Mena Ribas in
Google Scholar
PubMed
Search for other papers by Alicia Sanmartín Sánchez in
Google Scholar
PubMed
Search for other papers by Cesar Gonzalvo Diaz in
Google Scholar
PubMed
Search for other papers by Cristina Lamas in
Google Scholar
PubMed
Search for other papers by Raquel Guerrero-Vázquez in
Google Scholar
PubMed
Search for other papers by María del Castillo Tous in
Google Scholar
PubMed
Search for other papers by Joaquín Serrano in
Google Scholar
PubMed
Search for other papers by Theodora Michalopoulou in
Google Scholar
PubMed
Search for other papers by Eva María Moya Mateo in
Google Scholar
PubMed
Search for other papers by Felicia Hanzu in
Google Scholar
PubMed
Purpose
The aim of this study was to evaluate the prevalence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) and its implications on cardiometabolic and surgical outcomes.
Methods
This is a retrospective multicenter study of PA patients who underwent 1 mg dexamethasone-suppression test (DST) during diagnostic workup in 21 Spanish tertiary hospitals. ACS was defined as a cortisol post-DST >1.8 µg/dL (confirmed ACS if >5 µg/dL and possible ACS if 1.8–5 µg/dL) in the absence of specific clinical features of hypercortisolism. The cardiometabolic profile was compared with a control group with ACS without PA (ACS group) matched for age and DST levels.
Results
The prevalence of ACS in the global cohort of patients with PA (n = 176) was 29% (ACS–PA; n = 51). Ten patients had confirmed ACS and 41 possible ACS. The cardiometabolic profile of ACS–PA and PA-only patients was similar, except for older age and larger tumor size of the adrenal lesion in the ACS–PA group. When comparing the ACS–PA group (n = 51) and the ACS group (n = 78), the prevalence of hypertension (OR 7.7 (2.64–22.32)) and cardiovascular events (OR 5.0 (2.29–11.07)) was higher in ACS–PA patients than in ACS patients. The coexistence of ACS in patients with PA did not affect the surgical outcomes, the proportion of biochemical cure and clinical cure being similar between ACS–PA and PA-only groups.
Conclusion
Co-secretion of cortisol and aldosterone affects almost one-third of patients with PA. Its occurrence is more frequent in patients with larger tumors and advanced age. However, the cardiometabolic and surgical outcomes of patients with ACS–PA and PA-only are similar.
