Urinary tetrahydroaldosterone as a screening method for primary aldosteronism: a comparative study.

Background: The major aldosterone metabolite 3 alpha,5 beta tetrahydroaldosterone reflects up to 45% of the aldosterone secretion. Its 24-h urinary excretion is likely to provide an accurate index of the daily aldosterone production and to be an indicator for primary aldosteronism (PA).

Methods: In a prospective study, the validity of tetrahydroaldosterone as a screening test for PA was evaluated in comparison to serum potassium, plasma aldosterone, plasma renin activity, plasma aldosterone/renin activity ratio (PARR), as well as 24-h urinary aldosterone-18-glucuronide and free aldosterone.

Coexisting hyperparathyroidism, renal osteodystrophy and psoriatic arthritis.

We report the case of a 60-year-old woman with hyperparathyroidism, renal osteodystrophy and psoriatic arthritis. The coexistence of findings of hyperparathyroidism and renal osteodystrophy has been described and there are also reports of patients suffering from renal arthropathy mimicking hyperparathyroidism. To our knowledge, there is no description to date of a case displaying findings of the co-occurrence of these conditions in a patient.

Role of 21-deoxyaldosterone in human hypertension.

21-Deoxyaldosterone has been postulated to be a precursor of aldosterone in an alternative biosynthesis pathway and Kelly's-M1 is considered to be its metabolite. In healthy volunteers, the excretion rate of 21-deoxyaldosterone and of Kelly's-M1 are significantly lower than the aldosterone metabolites, aldosterone-18-glucuronide and tetrahydro-aldosterone and than the aldosterone precursor 18-OH-corticosterone. Essential hypertension patients (with low and normal renin) excrete comparable values of 21-deoxyaldosterone and Kelly's-M1 as normotensives.

[Retroperitoneal fibrosis].

A 53-year-old man without previous significant illness developed severe backache. Neither physiotherapy nor nonsteroidal anti-inflammatory drugs improved his condition so that he had been regularly taking pain-killing medication. 6 months later elevated retention values were detected and the patient was admitted to hospital.