1.Factors Associated with Resolution of Hypertension after Adrenalectomy in Patients with Primary Aldosteronism.
Wann Jia LOH ; Dawn Shao Ting LIM ; Lih Ming LOH ; Peng Chin KEK
Endocrinology and Metabolism 2018;33(3):355-363
BACKGROUND: The aim of this study was to investigate the factors associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism. A secondary aim was to describe our use of the contralateral ratio in adrenal venous sampling (AVS) in the setting of suboptimal successful cannulation rates. METHODS: A retrospective review of patients who underwent AVS followed by unilateral adrenalectomy for primary aldosteronism was performed. RESULTS: Complete resolution of hypertension and hypokalemia was seen in 17 of 40 patients (42.5%), while a clinical improvement in hypertension was seen in 38 of 40 (95%). Shorter duration of hypertension, mean aldosteronoma resolution score (ARS), and a high ARS of 3 to 5 were associated with resolution of hypertension after adrenalectomy (P=0.02, P=0.02, and P=0.004, respectively). Of the individual components of ARS, only a duration of hypertension of ≤6 years was associated with resolution of hypertension after adrenalectomy (P=0.03). CONCLUSION: A shorter duration of hypertension was significantly associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism.
Adrenalectomy*
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Catheterization
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Humans
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Hyperaldosteronism*
;
Hypertension*
;
Hypokalemia
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Retrospective Studies
2.Phaeochromocytoma presenting with pseudo-intestinal obstruction and lactic acidosis.
Peng Chin KEK ; Emily Tse Lin HO ; Lih Ming LOH
Singapore medical journal 2015;56(8):e131-3
Phaeochromocytomas are rare neuroendocrine tumours with variable clinical signs and symptoms. Hypertension, tachycardia, sweating and headaches are cardinal manifestations. Although nausea and abdominal pain are the more common gastrointestinal features, rare gastrointestinal spectrums have been reported that can mimic abdominal emergencies. Metabolic effects of hypercatecholaminaemia are vast and one such rare presentation is lactic acidosis. We describe a case of phaeochromocytoma presenting with both intestinal pseudo-obstruction as well as lactic acidosis. This case report highlights the importance of having a high index of suspicion for and early recognition of the gastrointestinal and metabolic manifestations of phaeochromocytomas.
Abdominal Pain
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Acidosis, Lactic
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complications
;
Adrenal Gland Neoplasms
;
complications
;
diagnosis
;
Diabetes Mellitus, Type 2
;
complications
;
Dyslipidemias
;
complications
;
Female
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Humans
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Hypertension
;
complications
;
Intestinal Pseudo-Obstruction
;
complications
;
Middle Aged
;
Neuroendocrine Tumors
;
complications
;
diagnosis
;
Pheochromocytoma
;
complications
;
diagnosis
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Radiography, Abdominal