Presentation
To present a case of central serous chorioretinopathy (CSC) treatment with spironolactone in a challenge-rechallenge pattern. [ncbi.nlm.nih.gov]
Entire Body System
Skin
- Macula
Funduscopy showed bilateral and unilateral myopic maculopathy, and Optical Coherence Tomography (OCT) showed a dome shaped macula with neurosensory detachment. [ncbi.nlm.nih.gov]
Eyes
- Retinal Cyst
The first patient had regions of neurosensory detachment (DNS) and the second, multiple DNS, secondary intra-retinal cysts and retinal pigment epithelium detachment. [ncbi.nlm.nih.gov]
- Retinal Pigmentation
The first patient had regions of neurosensory detachment (DNS) and the second, multiple DNS, secondary intra-retinal cysts and retinal pigment epithelium detachment. [ncbi.nlm.nih.gov]
Neurologic
- Headache
If potassium levels increase, anticipated symptoms would include cardiac irregularities, leg cramps, dryness of mouth, thirst, lethargy, drowsiness, and headaches. [aocd.org]
The most commonly reported side effects when taking Spiractin includes nausea, vomiting, headache, abdominal cramps and pain, diarrhoea, headache, drowsiness, lethargy, hair loss and excessive hair growth. [inhousepharmacy.vu]
Spironolactone is known to ameliorate mood and tension headache or migraine in women with premenstrual syndrome or clinical signs of hyperandrogenism. [ncbi.nlm.nih.gov]
Workup
Schlosser suggested considering an endocrinology workup in adult women who exhibit hirsutism, androgenetic alopecia, signs of virilization (deep voice, increased muscularity), acanthosis nigricans, central or abdominal obesity, oligomenorrhea/amenorrhea [medpagetoday.com]
Serum
- Potassium Increased
Blood urea nitrogen, potassium: increased levels Digoxin assays: false digoxin elevation Granulocytes: decreased count Drug-food. Potassium-containing salt substitutes, potassium-rich diet: increased risk of hyperkalemia Drug-herbs. [medical-dictionary.thefreedictionary.com]
If serum potassium increases during Spironolactona administration but drops when Spironolactona is discontinued, a presumptive diagnosis of primary hyperaldosteronism should be considered. [ndrugs.com]
Serum potassium increased by mean 0.41 mmol/L (95% CI: 0.37 to 0.44 mmol/L), sodium decreased by 1.7 mmol/L (95% CI: 1.5 to 1.9 mmol/L), and creatinine increased by 13.2 μmol/L (95% CI: 12.0 to 14.4 μmol/L). [hyper.ahajournals.org]
- HDL Increased
CONCLUSION: These data suggest that spironolactone use in transgender women increases HDL levels and that CPA has the opposite effect. CPA also is associated with a larger increase in prolactin. [ncbi.nlm.nih.gov]
Other Pathologies
- Myocardial Fibrosis
BACKGROUND: The effect of relaxin and spironolactone combined on myocardial fibrosis has not been reported. Thus, we investigated the effect of the combined therapy on isoprenaline-induced myocardial fibrosis and the mechanism. [ncbi.nlm.nih.gov]
Spironolactone reduces aldosterone-induced potassium/magnesium loss and myocardial fibrosis. It reduces hypertension, improves the endothelial function and reduces the overall morbidity and mortality in patients with chronic heart failure. [sigmaaldrich.com]
Treatment
It is concluded that the patient had a calcium-sensing receptor mutation, and that treatment with spironolactone induced an effect on renal handling of calcium in this condition. It is suggested that this treatment be tried in other similar patients. [ncbi.nlm.nih.gov]
The moderate side effects in no case forced interruption of the treatment. Hair growth diminished substantially in 23 of the patients, the effect becoming evident 3-5 months after the commencement of treatment. [doi.org]
Prognosis
It has been reported that mineralocorticoid receptor antagonist improves the prognosis of chronic heart failure (CHF). [ncbi.nlm.nih.gov]
Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation. 2012;125(13):1635–42 CrossRef 6. Rosa J, Widimský P, Waldauf P. [springermedizin.de]
McKinlay, Ph.D. for the TOPCAT Investigators * Article Figures/Media Metrics 36 References 744 Citing Articles 2 Comments Abstract Background Mineralocorticoid-receptor antagonists improve the prognosis for patients with heart failure and a reduced left [doi.org]
Etiology
Kim and Donald Tredway, Hirsutism: Implications, etiology, and management, American Journal of Obstetrics and Gynecology, 140, 7, (815), (1981). K.R. JONES, M. KATZ, C. KEYZER and W. [doi.org]
Epidemiology
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Sivamani, Epidemiology and Management of Acne in Adult Women, Current Dermatology Reports, 3, 1, (29), (2014) ., Take specific considerations into account when treating acne in patients with skin of colour, Drugs & Therapy Perspectives, 30, 7, (252), [doi.org]
Dieleman, senior researcher 1, Bruno Stricker, professor of pharmacoepidemiology 2, Miriam Sturkenboom, associate professor of pharmacoepidemiology 1 1 Department of Medical Informatics, Erasmus MC, PO Box 1738, 3000 Rotterdam, Netherlands 2 Department of Epidemiology [dx.doi.org]
Pathophysiology
Abstract: Mineralocorticoid receptor (MR) antagonism has proven to effectively attenuate the pathophysiological effects of aldosterone in clinical and experimental settings of hypertension and heart failure. [doi.org]
Since the isolation and purification of aldosterone from adrenal extracts 50 years ago (Experientia 9 (1953) 33), scientists have learned a great deal about how and where aldosterone acts, the factors that control its release, what is its role in the pathophysiology [ncbi.nlm.nih.gov]
Prevention
Long-term treatment with spironolactone controlled the hypertension and prevented hypokalemic alkalosis in this patient, without any deleterious effects on steroid biosynthesis. [ncbi.nlm.nih.gov]