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Outcome after surgery for primary hyperaldosteronism may depend on KCNJ5 tumor mutation status: a population-based study from Western Norway

Arnesen, Thomas (author)
Haukeland Hospital, Norway
Glomnes, Nina (author)
University of Bergen, Norway
Stromsoy, Siri (author)
University of Bergen, Norway
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Knappskog, Stian (author)
University of Bergen, Norway
Heie, Anette (author)
Haukeland Hospital, Norway
Akslen, Lars A. (author)
University of Bergen, Norway
Grytaas, Marianne (author)
Haukeland Hospital, Norway
Varhaug, Jan Erik (author)
Haukeland Hospital, Norway
Gimm, Oliver (author)
Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Kirurgiska kliniken US
Brauckhoff, Michael (author)
Haukeland Hospital, Norway
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 (creator_code:org_t)
2013-06-19
2013
English.
In: Langenbeck's archives of surgery (Print). - : Springer Verlag (Germany). - 1435-2443 .- 1435-2451. ; 398:6, s. 869-874
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Primary aldosteronism (PA) is a frequent cause (about 10 %) of hypertension. Some cases of PA were recently found to be caused by mutations in the potassium channel KCNJ5. Our objective was to determine the mutation status of KCNJ5 and seven additional candidate genes for tumorigenesis: YY1, FZD4, ARHGAP9, ZFP37, KDM5C, LRP1B, and PDE9A and, furthermore, the surgical outcome of PA patients who underwent surgery in Western Norway. less thanbrgreater than less thanbrgreater thanTwenty-eight consecutive patients with aldosterone-producing adrenal tumors (20 patients with single adenoma, 8 patients with unilateral multiple adenomas or hyperplasia) who underwent surgery were included in this study. All patients were operated on by uncomplicated laparoscopic total adrenalectomy. Genomic DNA was isolated from tumor and non-tumor adrenocortical tissue, and DNA sequencing revealed the mutation status. less thanbrgreater than less thanbrgreater thanTen out of 28 (36 %) patients with PA displayed tumor mutations in KCNJ5 (p. G151R and L168R) while none were found in the corresponding non-tumor samples. No mutations were found in the other seven candidate genes screened. The presence of KCNJ5 mutations was associated with lower blood pressure and a higher chance for cure by surgery when compared to patients harboring the KCNJ5 wild type. less thanbrgreater than less thanbrgreater thanKCNJ5 mutations are associated with a better surgical outcome. Preoperative identification of the mutation status might have impact on surgical strategy (total vs. subtotal adrenalectomy).

Keyword

Primary aldosteronism
Aldosterone-producing tumors
Conns syndrome
KCNJ5
Somatic mutations
Western Norway
MEDICINE
MEDICIN

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art (subject category)

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