Two elderly patients with mineralocorticoid excess due to 11 beta-hydroxysteroid dehydrogenase type 2 (11 beta-HSD2) impairment.
A 75-year-old woman had a low circulating level of aldosterone, despite the mineralocorticoid excess state. These abnormalities were improved by spironolactone administration. The distinct elevation of urinary cortisol/cortisone ratio revealed 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) impairment. Moreover, slight but distinct elevation of the ratio was found in a 95-year-old woman with normotension and normopotassemia. The mineralocorticoid excess state with reduced aldosterone level appeared following with vomiting and diarrhea, exaggerating asymptomatic impairment of 11beta-HSD2 to induce apparent mineralocorticoid excess (AME)-like condition.
Inada
Mitsuo
M
Department of Internal Medicine, Kizuyabashitakeda Hospital, Kyoto, Japan. kizuya@takedahp.or.jp
Iwasaki
Keiko
K
Imai
Chihiro
C
Hashimoto
Satoshi
S
D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2 / Q000097:blood* / Q000652:urine*; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood; D005260:Female; D006801:Humans; D008659:Metabolic Diseases / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D043204:Mineralocorticoid Excess Syndrome, Apparent / Q000097:blood / Q000175:diagnosis / Q000652:urine; D008901:Mineralocorticoids / Q000097:blood / Q000652:urine
D008901:Mineralocorticoids; D000450:Aldosterone; D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2