Postoperative adrenal insufficiency in Conn's syndrome-does it occur frequently?
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F22%3A10432729" target="_blank" >RIV/00064165:_____/22:10432729 - isvavai.cz</a>
Alternative codes found
RIV/00064173:_____/22:43922412 RIV/00216208:11110/22:10432729 RIV/00216208:11120/22:43922412
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=qoUnxx43rE" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=qoUnxx43rE</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1038/s41371-021-00618-0" target="_blank" >10.1038/s41371-021-00618-0</a>
Alternative languages
Result language
angličtina
Original language name
Postoperative adrenal insufficiency in Conn's syndrome-does it occur frequently?
Original language description
Primary aldosteronism (PA) is the most frequent form of endocrine hypertension. Recently, frequent clinically significant adrenal insufficiency after adrenalectomy in subjects with PA has been reported, which may make the early postsurgical management difficult. We retrospectively searched for possible adrenal insufficiency in subjects who underwent adrenalectomy for PA and have measured cortisol in the early postoperative course. We included subjects with confirmed diagnosis of PA who underwent either posture testing (blood draw at 06:00 and 08:00) and/or adrenal venous sampling (AVS) (blood draw between 08:00 and 09:00) and have also measured cortisol after surgery (cortisol measured approximately at 07:00). Cortisol was measured by immunoassay. In this study, we identified 150 subjects (age 48.5 +- 10.3 years) with available cortisol values in the early postoperative course (median [25th percentile, 75th percentile]) 6 [5,6] days. Postoperative cortisol values (551 +- 148 nmol/l) were normal and significantly higher, compared to preoperative standing cortisol values (404 +- 150 nmol/l; (P < 0.001) and AVS cortisol values (493 +- 198 nmol/l; P = 0.009), and did not significantly differ from preoperative supine cortisol values. Postsurgical cortisol values were not different among subjects with or without abnormal dexamethasone suppression test or elevated urinary free cortisol pre-surgery, and were significantly higher in subjects with abnormal diurnal cortisol variability compared with subjects with normal diurnal variability. No patient presented with adrenocortical crisis in the later follow-up. In conclusion, postoperative cortisol values did not indicate any suspicion of possible adrenal insufficiency. To exclude possible adrenal insufficiency, it may be sufficient to measure morning cortisol in the early postoperative course.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
<a href="/en/project/NV19-01-00083" target="_blank" >NV19-01-00083: IDENTIFICATION OF CRITICAL PROTEINS AND MOLECULAR PATHWAYS INVOLVED IN PHEOCHROMOCYTOMA AND PARAGANGLIOMA DEVELOPMENT AND PROGRESSION</a><br>
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of Human Hypertension
ISSN
0950-9240
e-ISSN
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Volume of the periodical
36
Issue of the periodical within the volume
6
Country of publishing house
GB - UNITED KINGDOM
Number of pages
7
Pages from-to
510-516
UT code for WoS article
000705700900002
EID of the result in the Scopus database
2-s2.0-85116442350