[PubMed] [Google Scholar] 5

[PubMed] [Google Scholar] 5. value for the Kpers prediction score was a score of 4, with an area under the curve (AUC) of 0.601 [95% confidence interval (CI) 0.551C0.650], specificity of 53%, and sensitivity of 62%. With a score of 5 as the cutoff value, which is the optimal Kpers score, the specificity reached 82% (95% CI 76C87%), but the sensitivity decreased to 32% (95% CI 26C39%). The positive likelihood ratio was 1.8 (95% CI 1.4C2.2), and the negative likelihood ratio was 0.8 (95% CI 0.6C1.1). eGFR was not significantly different between the two groups. A history of hypokalemia ((%). ARR, aldosterone-to-renin ratio; AVS, adrenal venous sampling; CT, computed tomography; eGFR, estimated glomerular filtration rate; KCL, potassium chloride; PAC, plasma aldosteronism concentration; PRA, plasma renin activity. Modified Kpers prediction score The quartiles of urinary aldosterone levels, history of hypokalemia, and typical Conn’s adenoma on CT (Table ?(Table3)3) were used to calculate the modified Kpers prediction score. We decreased the power of typical adenoma on CT from a score of 3 to 2, given the low concordance between CT imaging and AVS in our cohort (Table S1, Supplemental Digital Content 1, which shows the concordance of CT imaging and AVS results), resulting in a maximum score of 7. The AUC of our modified prediction score was 0.745 (95% CI 0.667C0.813), which is larger than that calculated by Kpers rule (0.635, 95% CI 0.552C0.713; evaluated 406 patients with primary aldosteronism and found that a combination of urinary aldosterone, hypokalemia history, and typical adenoma (1cm) on computed tomography might predict unilateral disease in young ( 40 years) patients or patients with right adrenal lesion. Strengths 1. Large number of participants 2. Clinically meaningful finding when adrenal venous sampling is not available or feasible Limitations 1. Limited generalization of study findings (only Chinese patients included, prediction only for young patients or patients with right adenoma) Footnotes Abbreviations: APA, aldosteronone-producing adenoma; ARR, aldosterone-to-renin ratio; AUC, area under the curve; AVS, Adrenal venous sampling; BAH, bilateral adrenal hyperplasia; CT, computed tomography; eGFR, estimated glomerular filtration rate; PA, primary aldosteronism; PAC, plasma aldosterone concentration; PRA, plasma renin activity; ROC, receiver operating characteristic; UAH, unilateral adrenal hyperplasia REFERENCES 1. Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. em J Clin Endocrinol Metab /em 2008; 93:3266C3281. [PubMed] [Google Scholar] 2. Muth A, Ragnarsson O, Johannsson G, W?ngberg B. Systematic review of surgery and outcomes in patients with primary aldosteronism. em Br J Surg /em 2015; 102:307C317. [PubMed] [Google Scholar] 3. Rossi GP, Barisa M, Allolio B, Auchus RJ, Amar L, Cohen D, et al. The Adrenal Vein Sampling International Study (AVIS) for identifying the major subtypes of primary aldosteronism. em J Clin Endocrinol Metab /em 2012; 97:1606C1614. [PubMed] [Google Scholar] 4. Rossi GP, Auchus RJ, Brown M, Lenders JW, Naruse M, Plouin PF, et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. em Hypertension /em 2014; 63:151C160. [PubMed] [Google Scholar] 5. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline. em J Clin Endocrinol Metab /em 2016; 101:1889C1916. [PubMed] [Google Scholar] 6. Kpers EM, Amar L, Raynaud A, Plouin PF, Steichen O. A clinical prediction score to diagnose unilateral primary aldosteronism. em J Clin Endocrinol Metab /em 2012; 97:3530C3537. [PubMed] [Google Scholar] 7. Riester A, Fischer E, Degenhart C, Reiser MF, Oxypurinol Bidlingmaier M, Beuschlein F, et al. Age below 40 or a recently proposed clinical prediction score cannot bypass adrenal venous sampling in primary aldosteronism. em J Clin Endocrinol Metab /em 2014; 99:E1035CE1039. [PubMed] [Google Scholar] 8. Venos ES, So B, Dias VC, Harvey A, Pasieka JL, Kline GA. A clinical prediction score for diagnosing unilateral primary aldosteronism may not be generalizable. em BMC Endocr Dis /em 2014;.Venos ES, So B, Dias VC, Harvey A, Pasieka JL, Kline GA. A clinical prediction score for diagnosing unilateral primary aldosteronism may not be generalizable. 62%. With a score of 5 as the cutoff value, which is the optimal Kpers score, the specificity reached 82% (95% CI 76C87%), but the sensitivity decreased to 32% (95% CI 26C39%). The positive likelihood ratio was 1.8 (95% CI 1.4C2.2), and the negative likelihood ratio was 0.8 (95% CI 0.6C1.1). eGFR was not significantly different between the two groups. A history of hypokalemia ((%). ARR, aldosterone-to-renin percentage; AVS, adrenal venous sampling; CT, computed tomography; eGFR, estimated glomerular filtration rate; KCL, potassium chloride; PAC, plasma aldosteronism concentration; PRA, plasma renin activity. Modified Kpers prediction score The quartiles of urinary aldosterone levels, history of hypokalemia, and standard Conn’s adenoma on CT (Table ?(Table3)3) were used to calculate the modified Kpers prediction score. We decreased the power of standard adenoma on CT from a score of 3 to 2, given the low concordance between CT imaging and AVS in our cohort (Table S1, Supplemental Digital Content 1, which shows the concordance of CT imaging and AVS results), resulting in a maximum score of 7. The AUC of our revised prediction score was 0.745 (95% CI 0.667C0.813), which is larger than that calculated by Kpers rule (0.635, 95% CI 0.552C0.713; evaluated 406 individuals with main aldosteronism and found that a combination of urinary aldosterone, hypokalemia history, and standard adenoma (1cm) on computed tomography might forecast unilateral disease in young ( 40 years) individuals or individuals with right adrenal lesion. Advantages 1. Large number of participants 2. Clinically meaningful getting when adrenal venous sampling is not available or feasible Limitations 1. Limited generalization of study findings (only Chinese individuals included, prediction only for young individuals or individuals with right adenoma) Footnotes Abbreviations: APA, aldosteronone-producing adenoma; ARR, aldosterone-to-renin percentage; AUC, area under the curve; AVS, Adrenal venous sampling; BAH, bilateral adrenal hyperplasia; CT, computed tomography; eGFR, estimated glomerular filtration rate; PA, main aldosteronism; PAC, plasma aldosterone concentration; PRA, plasma renin Oxypurinol activity; ROC, receiver operating characteristic; UAH, unilateral adrenal hyperplasia Referrals 1. Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, et al. Case detection, analysis, and treatment of individuals with main aldosteronism: an endocrine society clinical practice guideline. em J Clin Endocrinol Metab /em 2008; 93:3266C3281. [PubMed] [Google Rabbit polyclonal to CD20.CD20 is a leukocyte surface antigen consisting of four transmembrane regions and cytoplasmic N- and C-termini. The cytoplasmic domain of CD20 contains multiple phosphorylation sites,leading to additional isoforms. CD20 is expressed primarily on B cells but has also been detected onboth normal and neoplastic T cells (2). CD20 functions as a calcium-permeable cation channel, andit is known to accelerate the G0 to G1 progression induced by IGF-1 (3). CD20 is activated by theIGF-1 receptor via the alpha subunits of the heterotrimeric G proteins (4). Activation of CD20significantly increases DNA synthesis and is thought to involve basic helix-loop-helix leucinezipper transcription factors (5,6) Scholar] 2. Muth A, Ragnarsson O, Johannsson G, W?ngberg B. Systematic review of surgery and results in individuals with main aldosteronism. em Br J Surg /em 2015; 102:307C317. [PubMed] [Google Scholar] 3. Rossi GP, Barisa M, Allolio B, Auchus RJ, Amar L, Cohen D, et al. The Adrenal Vein Sampling International Study (AVIS) for identifying the major subtypes of main aldosteronism. em J Clin Endocrinol Metab /em 2012; 97:1606C1614. [PubMed] [Google Scholar] 4. Rossi GP, Auchus RJ, Brown M, Lenders JW, Naruse M, Plouin PF, et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of main aldosteronism. em Hypertension /em 2014; 63:151C160. [PubMed] [Google Scholar] 5. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of main aldosteronism: case detection, analysis, and treatment: an Endocrine Society clinical practice guideline. em J Clin Endocrinol Metab /em 2016; 101:1889C1916. [PubMed] [Google Scholar] 6. Kpers EM, Amar L, Raynaud A, Plouin PF, Steichen O. A medical prediction score to diagnose unilateral Oxypurinol main aldosteronism. em J Clin Endocrinol Metab /em 2012; 97:3530C3537. [PubMed] [Google Scholar] 7. Riester A, Fischer E, Degenhart C, Reiser MF, Bidlingmaier M, Beuschlein F, et al. Age below 40 or a recently proposed medical prediction score cannot bypass adrenal venous sampling in main aldosteronism. em J Clin Endocrinol Metab /em 2014; 99:E1035CE1039. [PubMed] [Google Scholar] 8. Venos Sera, So B, Dias VC, Harvey A, Pasieka JL, Kline GA. A medical prediction score for diagnosing unilateral main aldosteronism may not be generalizable. em BMC Endocr Dis /em .