Re: Thyroid cysts: a new extra-adrenal site of aldosterone synthase expression and increased aldosterone content

[Guest guest]

Nice article. I know Dr. Stern fairly well and worked with him when

we were in LA.

CE Grim MD

On Aug 20, 2008, at 5:57 PM, Valarie wrote:

> Thyroid cysts: a new extra-adrenal site of aldosterone synthase

> expression

> and increased aldosterone content

>

> Yona Greenman*, Yana Trostanetsky*, Sarit Ben-Shemen*, Nili Grazas

> <http://www3.interscience.wiley.com/journal/117998313/abstract#fn1>

> ‡, Rona

> Limor*, Etty Osher*, Sabina Lewicka†, Vecsei† and Naftali Stern*

> *Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv –

> Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel ,

> †Institute of Pharmacology, Ruprecht-Karls-University, Heidelberg,

> Germany

>

> Correspondence: Naftali Stern, Institute of Endocrinology, Tel Aviv –

> Sourasky Medical Center, 6 Weizmann St. Tel Aviv 64239, Israel.

> Tel: +972

> 36973732; Fax: +972 36974578; E-mail: <mailto:>

> stern@...

>

> Copyright © 2007 The Authors

> Journal compilation © 2007 Blackwell Publishing Ltd

> Summary

>

>

> Background The rapid re-accumulation of fluid following aspiration of

> thyroid cystic lesions suggests that active transport of sodium and

> water

> may be involved in volume regulation of these lesions. In this

> study we

> address the possibility that aldosterone may take part in this

> process.

>

> Subjects and methods Thirty-one patients (29 women and two men),

> with a mean

> age of 52·7 ± 13·2 years (range: 27–77 years) underwent evaluation for

> thyroid nodules that had a sonographic cystic component. Cystic fluid

> obtained by FNA biopsy was sent for cytological examination and

> biochemical

> measurements. In 10 patients, material was collected for RNA

> extraction and

> determination of aldosterone synthase expression by RT-PCR

> amplification.

>

> Results All lesions were benign, cystic, colloid nodules. Cyst fluid

> aldosterone levels as measured by routine radioimmunoassay (RIA) were

> elevated above the normal plasma levels in all but five patients. Mean

> aldosterone levels were 27·1 ± 22·9 ng/dl (SD) (range: 5·9–117·5 ng/

> dl). In

> contrast, cyst cortisol values were in the low, low normal serum

> range (6·2

> ± 2·9 µg/dl, range: 0·2–10·2 µg/dl). Sodium, chloride and potassium

> levels

> were 137 ± 4·7 mEq/l, 98 ± 5 mEq/l and 4·9 ± 1·4 mEq/l,

> respectively. Plasma

> aldosterone levels were normal in all patients tested. To confirm

> these

> results, 12 samples were assayed after extraction and

> chromatography using a

> highly specific antibody. Cyst aldosterone levels in this group were

> elevated above the normal serum range in all but one patient (mean

> concentration: 24·5 ± 14·6 ng/dl, range: 8·72–40·1 ng/dl). In this

> group,

> 18(OH)B levels were within the normal plasma range (12–55 ng/dl) in

> all but

> one patient (34·9 ± 17 ng/dl). Furthermore, aldosterone synthase mRNA

> expression was found in aspirates of four of 10 patients.

>

> Conclusions The increased aldosterone concentration and the

> presence of

> aldosterone synthase expression suggest that aldosterone may be

> locally

> produced and secreted in thyroid tissue. The pathophysiological

> implications

> of this finding remain to be established.

> _____

>

> (Received 13 September 2006; returned for revision 27 October 2006;

> finally

> revised 25 December 2006; accepted 4 January 2007)

>

>

>

>