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Apparent mineralocorticoid excess syndrome
Classification and external resources
OMIM 218030
DiseasesDB 12740
MeSH D043204

Apparent mineralocorticoid excess (AME) is an autosomal recessive[1] disorder causing hypertension (high blood pressure) and hypokalemia (abnormally low levels of potassium). The condition responds to glucocorticoid treatment. It results from mutations in the HSD11B2 gene, which encodes the kidney isozyme of 11β-hydroxysteroid dehydrogenase. In an unaffected individual, this isozyme inactivates circulating cortisol to the less-active metabolite cortisone. The inactivating mutation leads to elevated local concentrations of cortisol in the kidney. Cortisol at high concentrations can cross-react and activate the mineralocorticoid receptor, leading to aldosterone-like effects in the kidney. This is what causes the hypokalemia, hypertension, and hypernatremia associated with the syndrome.

Other conditions such as Liddle's Syndrome can mimic the clinical features of AME, so diagnosis can made my calculating the ratio of free urinary cortisol to free urinary cortisone. Since AME patients create less cortisone, the ratio will much be higher than non-affected patients.[2]

AME is exceedingly rare, with less than 100 cases recorded worldwide.[2]

Licorice ingestion due to its ability to block 11β-hydroxysteroid dehydrogenase type 2 by glycyrrhetinic acid may also cause AME due to increased activity of cortisol. Cessation of licorice consumption will reverse this form of AME.



Apparent mineralocorticoid excess syndrome has an autosomal recessive pattern of inheritance.

AME is inherited in an autosomal recessive manner.[1] This means the defective gene responsible for the disorder is located on an autosome, and two copies of the defective gene (one inherited from each parent) are required in order to be born with the disorder. The parents of an individual with an autosomal recessive disorder both carry one copy of the defective gene, but usually do not experience any signs or symptoms of the disorder.


  1. ^ a b Levtchenko EN, Deinum J, Knoers NV, Hermus AR, Monnens LA, Lenders JW (Mar 2007). "From gene to disease; 'apparent mineralocorticoid excess' syndrome, a syndrome with an apparent excess of mineral corticoids". Nederlands tijdschrift voor geneeskunde 151 (12): 692–694. PMID 17447595.    edit
  2. ^ a b Palermo M, Quinkler M, Stewart PM. (Oct 2004). "Apparent mineralocorticoid excess syndrome: an overview.". Epub 48 (5): 687–696. doi:10.1590/S0004-27302004000500015. PMID 15761540.  

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