New fast screening test for primary hyperaldosteronism (PHA): Determination of plasma aldosterone to renin ratio using recently available mechanised chemiluminescence immunoassays

2004 ◽  
Vol 112 (S 1) ◽  
Author(s):  
FH Perschel ◽  
R Schemer ◽  
L Seiler ◽  
M Reincke ◽  
D Mechelhoff ◽  
...  
Keyword(s):  
Screening Test ◽  
Plasma Aldosterone ◽  
Primary Hyperaldosteronism ◽  
Fast Screening ◽  
Aldosterone To Renin Ratio

scholarly journals Rapid Screening Test for Primary Hyperaldosteronism: Ratio of Plasma Aldosterone to Renin Concentration Determined by Fully Automated Chemiluminescence Immunoassays

2004 ◽  
Vol 50 (9) ◽  
pp. 1650-1655 ◽  
Author(s):  
Frank Holger Perschel ◽  
Rudolf Schemer ◽  
Lysann Seiler ◽  
Martin Reincke ◽  
Jaap Deinum ◽  
...  
Keyword(s):  
Screening Test ◽  
Screening Method ◽  
Plasma Renin ◽  
Preliminary Evidence ◽  
Plasma Aldosterone ◽  
Primary Hyperaldosteronism ◽  
Rapid Screening ◽  
Plasma Aldosterone Concentration ◽  
Rapid Screening Test ◽  
Edta Plasma

Abstract Background: The ratio of plasma aldosterone concentration to plasma renin activity (PAC/PRA) is the most common screening test for primary hyperaldosteronism (PHA), but it is not standardized among laboratories. We evaluated new automated assays for the simultaneous measurement of PAC and plasma renin concentration (PRC). Methods: We studied 76 healthy normotensive volunteers and 28 patients with confirmed PHA. PAC and PRC were measured immunochemically in EDTA plasma on the Nichols Advantage® chemiluminescence analyzer, and PRA was determined by an activity assay. Results: In volunteers, PAC varied from 33.3 to 1930 pmol/L, PRA from 1.13 to 19.7 ng · mL−1 · h−1 (0.215 ng · mL−1 · h−1 = 1 pmol · L−1 · s−1), and PRC from 5.70 to 116 mU/L. PAC/PRA ratios ranged from 4.35 to 494 (pmol/L)/(ng · mL−1 · h−1) and PAC/PRC ratios from 0.69 to 71.0 pmol/mU. In PHA patients, PAC ranged from 158 to 5012 pmol/L, PRA from 0.40 to 1.70 ng · mL−1 · h−1, and PRC from 0.80 to 11.7 mU/L. PAC/PRA ratios were between 298 and 6756 (pmol/L)/(ng · mL−1 · h−1) and PAC/PRC ratios between 105 and 2328 pmol/mU. Whereas PAC or PRC showed broad overlap between PHA patients and volunteers, the PAC/PRC ratio indicated distinct discrimination of these two groups at a cutoff of 71 pmol/mU. Conclusion: The PAC/PRC ratio offers several practical advantages compared with the PAC/PRA screening method. The present study offers preliminary evidence that it may be a useful screening test for PHA. Further studies are required to validate these results, especially in hypertensive cohorts.

The Aldosterone-to-Renin Ratio as a Screening Test in Primary Aldosteronism

2021 ◽  
Vol 14 (63) (1) ◽  
pp. 29-36
Author(s):  
Manuela Mocanu ◽  
Claudia Alexandrina Irimie ◽  
Mihai Stelian Vârciu ◽  
Marius Irimie
Keyword(s):  
Primary Aldosteronism ◽  
Screening Test ◽  
Target Population ◽  
Secondary Hypertension ◽  
Primary Hypertension ◽  
Primary Hyperaldosteronism ◽  
Common Causes ◽  
Aldosterone To Renin Ratio

Primary hyperaldosteronism is one of the most common causes of secondary hypertension and it is associated with a higher risk of developing extracardiac complications than that of people diagnosed with primary hypertension. We present a six-month study done at the MedLife Hospital in Brașov on 62 patients who had one or more indications for primary hyperaldosteronism screening. The main conclusions drawn from this study are that there is a strong need for starting screening in primary hyperaldosteronism from an earlier age, as the target population can have a high vulnerability from a cardiovascular and a renal standpoint and that the aldosterone-to-renin ratio screening test should be recommended to a higher number of people in the target population, the positivity rate in the group studied being 47%.

Laboratory Detection of Female Carriers of Canine Hemophilia

1964 ◽  
Vol 12 (02) ◽  
pp. 368-376 ◽  
Author(s):  
B. J Parks ◽  
K. M Brinkhous ◽  
P. F Harris ◽  
G. D Penick
Keyword(s):  
Factor Viii ◽  
Partial Thromboplastin Time ◽  
Screening Test ◽  
Factor Viii Level ◽  
Viii Level ◽  
Antihemophilic Factor ◽  
Female Carriers

SummaryFemales known to be heterozygous for canine hemophilia had a plasma antihemophilic factor (AHF, factor VIII) level of about 50%, as determined by bioassay and by the effectiveness of their transfused plasma in raising the AHF levels of hemophilic dogs. Determination of the plasma AHF should serve to identify transmitter females prior to appearance of affected progeny in litters. Lyon’s hypothesis appears to apply to our findings.The simple partial thromboplastin time (PTT) test was prolonged in heterozygous females. Modifications of the test, by the addition of thrombin, a serum accelerator preparation, or kaolin, gave consistently longer PTT values for heterozygotes than for normal dogs. The PTT appears useful as a screening test for carriers of canine hemophilia.

Evaluation of Biochemical Conditions Allowing Bypass of Confirmatory Testing in The Workup of Primary Aldosteronism: A Retrospective Study in a French Hypertensive Population

2019 ◽  
Vol 51 (03) ◽  
pp. 172-177 ◽  
Author(s):  
Maud Vivien ◽  
Emilie Deberles ◽  
Remy Morello ◽  
Aimi Haddouche ◽  
David Guenet ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Dynamic Testing ◽  
Challenge Test ◽  
Plasma Aldosterone ◽  
Aldosterone Secretion ◽  
Plasma Aldosterone Concentration ◽  
Hypertensive Patients ◽  
Hypertensive Population ◽  
Tertiary Center ◽  
Aldosterone To Renin Ratio

AbstractThe diagnostic workup for primary aldosteronism includes a screening step using the aldosterone-to-renin ratio (ARR) and a confirmatory step based on dynamic testing of aldosterone secretion autonomy. International guidelines suggest that precise clinical and biochemical conditions may allow the bypassing of the confirmatory step, however, data which validate hormone thresholds defining such conditions are lacking. At our tertiary center, we retrospectively examined a cohort of 173 hypertensive patients screened for PA by the ARR, of whom 120 had positive screening and passed a saline infusion test (SIT) or a captopril challenge test (CCT). Fifty-nine had PA, including 34 Conn adenomas and 25 with idiopathic aldosteronism (IA). Using a threshold of 160 pmol/l, post-SIT plasma aldosterone concentration (PAC) identified PA with 86.4% sensitivity, 94.7% specificity, and a negative predictive value of 92.3%. Of those subjects with a high ARR and a PAC above 550 pmol/l, 93% had a positive SIT, while 100% of subjects with a high ARR, but a PAC under 240 pmol/l had a negative SIT. Our results thus validate the biochemical conditions defined in the French and US guidelines for bypassing the confirmatory step in the workup for PA diagnosis.

CHRONIC LEAD ENCEPHALOPATHY

PEDIATRICS ◽  
1960 ◽  
Vol 25 (2) ◽  
pp. 309-315
Author(s):  
Harry H. White ◽  
Fred D. Fowler
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pediatric Patients ◽  
Early Recognition ◽  
Central Nervous System Involvement ◽  
Fast Screening ◽  
The Central Nervous System ◽  
Lead Encephalopathy ◽  
Urinary Coproporphyrin

Chronic lead encephalopathy must be considered in the differential diagnosis of pediatric patients who present with manifestations of schizophrenia, behavior disorders or degenerative diseases of the central nervous system. Determination of urinary coproporphyrin is a simple, fast screening procedure applicable to office practice. The prognosis for normal mental development following encephalopathy is poor. It is hoped that early recognition of the more subtle signs of central nervous system involvement will allow treatment to be instituted soon enough to prevent the crippling mental deterioration which is so often a sequela of lead poisoning.

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