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The pathogenesis of pseudohyperaldosteronism from carbenoxolone
D Armanini1, M Scali, M C Zennaro
1Istituto Semeiotica Medica, Università di Padova, Italy.
Journal of Endocrinological Investigation
|May 1, 1989
Summary
Carbenoxolone treatment causes pseudohyperaldosteronism by initially amplifying steroid effects and later exerting a direct mineralocorticoid-like action. This study investigated its electrolyte and hormonal impacts in healthy volunteers.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Carbenoxolone, a glycyrrhetinic acid derivative, treats peptic ulcers and gastritis.
- A common side effect is salt and water retention, mimicking hyperaldosteronism.
Purpose of the Study:
- To investigate the mechanisms of carbenoxolone-induced pseudohyperaldosteronism.
- To analyze the drug's effects on electrolyte balance and hormonal levels.
Main Methods:
- Studied 6 male volunteers during a 7-day carbenoxolone treatment.
- Measured serum, urinary, and sweat electrolytes.
- Assessed plasma renin activity (PRA), cortisol, aldosterone, and mineralocorticoid receptor-binding factors.
Main Results:
- Electrolyte changes indicated a mineralocorticoid-like effect.
- PRA, cortisol, and aldosterone levels decreased during treatment.
- Factors binding to mineralocorticoid receptors initially decreased, then increased by day 7, suggesting dual mechanisms.
Conclusions:
- Carbenoxolone's pseudohyperaldosteronism involves initial amplification of endogenous steroid action.
- Higher drug concentrations may lead to a direct mineralocorticoid-like effect.
- The drug exhibits a dual mechanism in inducing mineralocorticoid-like effects.