7
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Mulatero P, Tauber P, Zennaro MC, Monticone S, Lang K, Beuschlein F, Fischer E, Tizzani D, Pallauf A, Viola A, Amar L, Williams TA, Strom TM, Graf E, Bandulik S, Penton D, Plouin PF, Warth R, Allolio B, Jeunemaitre X, Veglio F, Reincke M. KCNJ5
Mutations in European Families With Nonglucocorticoid Remediable Familial Hyperaldosteronism. Hypertension 2012; 59:235-40. [DOI: 10.1161/hypertensionaha.111.183996] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Paolo Mulatero
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Philipp Tauber
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Maria-Christina Zennaro
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Silvia Monticone
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Katharina Lang
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Felix Beuschlein
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Evelyn Fischer
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Davide Tizzani
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Anna Pallauf
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Andrea Viola
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Laurence Amar
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Tracy Ann Williams
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Tim M. Strom
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Elisabeth Graf
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Sascha Bandulik
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - David Penton
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Pierre-François Plouin
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Richard Warth
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Bruno Allolio
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Xavier Jeunemaitre
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Franco Veglio
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
| | - Martin Reincke
- From the Division of Internal Medicine and Hypertension (P.M., S.M., D.T., A.V., T.A.W., F.V.), University of Torino, Torino, Italy; Medical Cell Biology (P.T., S.B., D.P., R.W.), University Regensburg, Regensburg, Germany; Institut National de la Santé et de la Recherche Médicale (M.C.Z., L.A., P.F.P., X.J.), U970, Paris Cardiovascular Research Center, Paris, France; University Paris Descartes (M.C.Z., L.A., P.F.P., X.J.), Paris, France; Assistance Publique-Hôpitaux de Paris (M.C.Z., L.A., P.F.P.,
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8
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Carvajal CA, Campino C, Martinez-Aguayo A, Tichauer JE, Bancalari R, Valdivia C, Trejo P, Aglony M, Baudrand R, Lagos CF, Mellado C, Garcia H, Fardella CE. A New Presentation of the Chimeric CYP11B1/CYP11B2 Gene With Low Prevalence of Primary Aldosteronism and Atypical Gene Segregation Pattern. Hypertension 2012; 59:85-91. [DOI: 10.1161/hypertensionaha.111.180513] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Familial hyperaldosteronism type I is caused by an unequal crossover of 11β-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) genes, giving rise to a chimeric CYP11B1/CYP11B2 gene (CG). We describe a family carrying a CG with high levels of free 18-hydroxycortisol but low prevalence of primary aldosteronism (PA) and an atypical CG inheritance pattern in a family of 4 generations with 16 adults and 13 children, we measured the arterial blood pressure, serum aldosterone, and plasma renin activity and then calculated the serum aldosterone:plasma renin activity ratio and urinary free 18-hydroxycortisol. We identified the CG by long-extension PCR and predicted its inheritance pattern. The CG was found in 24 of 29 subjects (10 children and 14 adults). In CG+ patients, hypertension and high 18-hydroxycortisol were prevalent (83% and 100%, respectively). High serum aldosterone:plasma renin activity ratio was more frequent in pediatric than adult patients (80% versus 36%;
P
<0.001). An inverse association between serum aldosterone:plasma renin activity ratio and age was observed (
r
=−0.48;
P
=0.018). Sequence analysis identified the CYP11B1/CYP11B2 crossover in a 50-bp region spanning intron 3 of CYP11B1 and exon 4 of CYP11B2. The CG segregation differs from an autosomal disease, showing 100% of CG penetrance in generations II and III. Statistical analysis suggests that inheritance pattern was not attributed to random segregation (
P
<0.001). In conclusion, we describe a family with an atypical CYP11B1/CYP11B2 gene inheritance pattern and variable phenotypic expression, where the majority of pediatric patients have primary aldosteronism. Most adults have normal aldosterone and renin levels, which could mask them as essential hypertensives.
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Affiliation(s)
- Cristian A. Carvajal
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Carmen Campino
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Alejandro Martinez-Aguayo
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Juan E. Tichauer
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Rodrigo Bancalari
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Carolina Valdivia
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Pamela Trejo
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Marlene Aglony
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - René Baudrand
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Carlos F. Lagos
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Cecilia Mellado
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Hernán Garcia
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
| | - Carlos E. Fardella
- From the Department of Endocrinology (C.A.C., C.C., J.E.T., C.V., P.T., R.B., C.F.L., C.E.F.), Division of Pediatrics (A.M.-A., R.B., M.A., C.M., H.G.), Faculty of Medicine, and Department of Pharmacy, Faculty of Chemistry (C.F.L.), Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute of Immunology and Immunotherapy (C.A.C., C.C., R.B., C.E.F.), Santiago, Chile
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10
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Mulatero P, Tizzani D, Viola A, Bertello C, Monticone S, Mengozzi G, Schiavone D, Williams TA, Einaudi S, La Grotta A, Rabbia F, Veglio F. Prevalence and Characteristics of Familial Hyperaldosteronism. Hypertension 2011; 58:797-803. [DOI: 10.1161/hypertensionaha.111.175083] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary aldosteronism (PA) is the most frequent cause of secondary hypertension, and patients display an increased prevalence of cardiovascular events compared with essential hypertensives. To date, 3 familial forms of PA have been described and termed familial hyperaldosteronism types I, II, and III (FH-I to -III). The aim of this study was to investigate the prevalence and clinical characteristics of the 3 forms of FH in a large population of PA patients. Three-hundred consecutive PA patients diagnosed in our unit were tested by long-PCR of the
CYP11B1/CYP11B2
hybrid gene that causes FH-I, and all of the available relatives of PA patients were screened to confirm or exclude PA and, thus, FH-II. Urinary 18-hydroxycortisol and 18-oxocortisol were measured in all of the familial PA patients. Two patients were diagnosed with FH-I (prevalence: 0.66%), as well as 21 of their relatives, and clinical phenotypes of the 2 affected families varied markedly. After exclusion of families who refused testing and those who were not informative, 199 families were investigated, of which 12 were diagnosed with FH-II (6%) and an additional 15 individuals had confirmed PA; clinical and biochemical phenotypes of FH-II families were not significantly different from sporadic PA patients. None of the families displayed a phenotype compatible with FH-III diagnosis. Our study demonstrates that familial forms of hyperaldosteronism are more frequent than previously expected and reinforces the recommendation of the Endocrine Society Guidelines to screen all first-degree hypertensive relatives of PA patients.
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Affiliation(s)
- Paolo Mulatero
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Davide Tizzani
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Andrea Viola
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Chiara Bertello
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Silvia Monticone
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Giulio Mengozzi
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Domenica Schiavone
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Tracy Ann Williams
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Silvia Einaudi
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Antonio La Grotta
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Franco Rabbia
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
| | - Franco Veglio
- From the Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension (P.M., D.T., A.V., C.B., S.M., D.S., T.A.W., F.R., F.V.), and Department of Endocrinology and Diabetology, Regina Margherita Pediatric Hospital (S.E.), University of Torino, Torino, Italy; Clinical Chemistry Laboratory (G.M.), San Giovanni Battista University Hospital, Torino, Italy; Division of Internal Medicine (A.L.G.), Service of Endocrinology and Hypertension, Cardinal Massaia Hospital,
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