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Query: UMLS:C0023890 (
cirrhosis
)
42,195
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A patient with
cirrhosis
and coexistent
hyporeninemic hypoaldosteronism
secondary to diabetic nephropathy rapidly formed ascites despite marked reductions in plasma aldosterone concentration and urinary aldosterone excretion. To my knowledge, this association has not been previously reported. This case supports the concept that hyperaldosteronism is not a necessary component of the salt retention of advanced liver disease. Furthermore, it suggests that certain renal disorders should be considered in cases of
cirrhosis
and ascites with decreased plasma renin activity.
...
PMID:Hyporeninemic hypoaldosteronism in a patient with cirrhosis and ascites. 353 21
A 49-year-old man with
liver cirrhosis
and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was
hyporeninemic hypoaldosteronism
and this was aggravated by other factors or drugs affecting potassium homeostasis.
...
PMID:Hyperkalemia due to hyporeninemic hypoaldosteronism with liver cirrhosis and hypertension. 817 35
Selective iron deposition in the zona glomerulosa of the adrenal cortex is observed in hemochromatosis. Hypoaldosteronism should be excluded before starting venesection, to avoid long-term volume depletion. We evaluated the aldosterone status in patients with hemochromatosis. As other endocrine organs can be affected by the disease as well, we simultaneously evaluated anterior pituitary, gonadal, thyroid and pancreatic beta-cell activity. Nine patients with hereditary or acquired hemochromatosis and highly increased plasma ferritin levels were investigated. In patients,
liver cirrhosis
had been confirmed histologically. Five patients complained of sexual dysfunction, and one had impaired glucose tolerance. Plasma aldosterone (PA) and renin activity (PRA) were measured after a period of normal (100 mmol/day) and low (10 mmol/day) sodium intake. A combined anterior pituitary function test and a glucagon stimulation test were undertaken to evaluate other endocrine functions. Both PA and PRA levels were decreased in one patient with
liver cirrhosis
, who also presented attenuated cortisol, prolactin and gonadotrophin secretion. No patients had signs of primary hypoaldosteronism with hyperreninemia. Hypogonadotropic hypogonadism was observed in 3 males and 1 female. Pituitary ACTH reserve was impaired in 2, GH and prolactin response in 1, and thyroid function in none of the patients. Glucagon-stimulated plasma C-peptide was impaired in one patient. In conclusion, primary aldosterone deficiency was not observed in patients with severe iron overload.
Hyporeninemic hypoaldosteronism
was found in one patient who also presented other endocrinopathies. Hypogonadotropic hypogonadism is the most frequent endocrine abnormality in hemochromatosis.
...
PMID:Mineralocorticoid status and endocrine dysfunction in severe hemochromatosis. 1040 11