Hypoaldosteronism pathophysiology

Hypoaldosteronism Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Hypoaldosteronism is defined as decreased levels of the hormone aldosterone (Normal range: 1-21 ng/dL). Hypoaldosteronism from decreased aldosterone synthesis can be due to :

• Adrenal Insufficiency: Primary or secondary
• Enzyme deficiency: Aldosterone synthase, 21 hydroxylase, and 11B hydroxylase
• Renal disorders: Chronic renal failure and diabetic nephropathy
• Drugs inhibiting aldosterone effect: NSAID, spironolactone, and triamterene

Pathophysiology

Pathogenesis

• The exact pathogenesis of [disease name] is not fully understood.

OR

• It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
• [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
• Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
• [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
• The progression to [disease name] usually involves the [molecular pathway].
• The pathophysiology of [disease/malignancy] depends on the histological subtype.

Genetics

• Hypoaldosteronism is transmitted in autosomal recessive pattern.
• Gene involved in the pathogenesis of hypoaldosteronism include mutation in CYP11B2 gene, which is located on chromosome 8q24.
• The CYP11B2 gene encodes for the enzyme aldosterone synthase (previously known as corticosterone methyloxidase).
• Aldosterone synthase catalyses the three terminal steps of aldosterone biosynthesis: 11β-hydroxylation of DOC to corticosterone, 18-hydroxylation to 18-hydroxycorticosterone, and 18-oxidation to aldosterone
• Mutations in CYP11B2 can lead to:
  • Type 1 aldosterone synthase deficiency: Patients has normal to decreased levels of 18-hydroxycorticosterone and undetectable levels of aldosterone.
  • Type 2 aldosterone synthase deficiency: Patients has increased levels of 18-hydroxycorticosterone and normal to decreased levels of aldosterone.
• Aldosterone synthase is a member of the cytochrome P450 family of enzymes.

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].