Army Medical Service (Germany): Difference between revisions

Revision as of 17:19, 11 February 2025

Apparent Mineralocorticoid Excess Syndrome

Apparent Mineralocorticoid Excess Syndrome (AME) is a rare genetic disorder characterized by hypertension, hypokalemia, metabolic alkalosis, and low plasma renin activity. It is caused by mutations in the gene encoding the enzyme 11_-hydroxysteroid dehydrogenase type 2 (11_-HSD2), which is responsible for converting active cortisol to its inactive form, cortisone.

Pathophysiology

The 11_-hydroxysteroid dehydrogenase type 2 enzyme plays a crucial role in protecting the mineralocorticoid receptor from activation by cortisol. In individuals with AME, the deficiency or dysfunction of this enzyme leads to an accumulation of cortisol, which can bind to and activate the mineralocorticoid receptor. This results in effects similar to those of excessive aldosterone, despite normal or low levels of aldosterone in the body.

Genetics

AME is inherited in an autosomal recessive manner. This means that an individual must inherit two copies of the mutated gene, one from each parent, to manifest the disorder. The gene responsible for AME is located on chromosome 16 and is known as HSD11B2.

Clinical Features

Patients with AME typically present with:

Severe hypertension
Hypokalemia (low potassium levels)
Metabolic alkalosis
Low plasma renin activity
Normal or low levels of aldosterone

Diagnosis

The diagnosis of AME is based on clinical features, biochemical tests, and genetic testing. Biochemical tests reveal low renin and aldosterone levels, along with hypokalemia and metabolic alkalosis. Genetic testing can confirm mutations in the HSD11B2 gene.

Treatment

Treatment of AME focuses on managing hypertension and correcting electrolyte imbalances. Medications such as spironolactone or eplerenone, which are mineralocorticoid receptor antagonists, can be used to block the effects of cortisol on the mineralocorticoid receptor. Dietary modifications, such as reducing sodium intake and increasing potassium intake, may also be beneficial.

Related Pages

Gallery

Inheritance pattern of autosomal recessive disorders

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-'''Army Medical Service (Germany)''' is the branch of the [[German Armed Forces]] responsible for providing medical care to military personnel and their families. The service is composed of medical professionals from various disciplines, including [[physicians]], [[nurses]], [[pharmacists]], and [[medical technicians]]. The Army Medical Service operates military hospitals, clinics, and field hospitals, and also provides medical support during military operations.
+== Apparent Mineralocorticoid Excess Syndrome ==
-== History ==
+'''Apparent Mineralocorticoid Excess Syndrome''' (AME) is a rare genetic disorder characterized by hypertension, hypokalemia, metabolic alkalosis, and low plasma renin activity. It is caused by mutations in the gene encoding the enzyme 11_-hydroxysteroid dehydrogenase type 2 (11_-HSD2), which is responsible for converting active cortisol to its inactive form, cortisone.
-The Army Medical Service was established in the early 19th century, during the [[Napoleonic Wars]]. It was initially a small organization, but it grew rapidly as the need for medical care in the military became more apparent. The service played a crucial role in both World Wars, providing medical care to wounded soldiers and civilians alike.
+=== Pathophysiology ===
+The [[11_-hydroxysteroid dehydrogenase type 2]] enzyme plays a crucial role in protecting the mineralocorticoid receptor from activation by [[cortisol]]. In individuals with AME, the deficiency or dysfunction of this enzyme leads to an accumulation of cortisol, which can bind to and activate the mineralocorticoid receptor. This results in effects similar to those of excessive [[aldosterone]], despite normal or low levels of aldosterone in the body.
-== Structure ==
+=== Genetics ===
+AME is inherited in an [[autosomal recessive]] manner. This means that an individual must inherit two copies of the mutated gene, one from each parent, to manifest the disorder. The gene responsible for AME is located on chromosome 16 and is known as HSD11B2.
-The Army Medical Service is divided into several branches, each responsible for a specific area of medical care. These include the Medical Corps, the Dental Corps, the Veterinary Corps, and the Medical Service Corps. Each corps is composed of officers who are trained in their respective medical fields.
+=== Clinical Features ===
+Patients with AME typically present with:
+* Severe [[hypertension]]
+* [[Hypokalemia]] (low potassium levels)
+* [[Metabolic alkalosis]]
+* Low plasma renin activity
+* Normal or low levels of aldosterone
-== Training ==
+=== Diagnosis ===
+The diagnosis of AME is based on clinical features, biochemical tests, and genetic testing. Biochemical tests reveal low renin and aldosterone levels, along with hypokalemia and metabolic alkalosis. Genetic testing can confirm mutations in the HSD11B2 gene.
-Training for the Army Medical Service is rigorous and comprehensive. It includes both military and medical training, with a focus on trauma care and emergency medicine. The training program is designed to prepare medical personnel for the unique challenges of providing medical care in a military environment.
+=== Treatment ===
+Treatment of AME focuses on managing hypertension and correcting electrolyte imbalances. Medications such as [[spironolactone]] or [[eplerenone]], which are mineralocorticoid receptor antagonists, can be used to block the effects of cortisol on the mineralocorticoid receptor. Dietary modifications, such as reducing sodium intake and increasing potassium intake, may also be beneficial.
-== Role in Military Operations ==
+== Related Pages ==
+* [[Hypertension]]
+* [[Hypokalemia]]
+* [[Metabolic alkalosis]]
+* [[Aldosterone]]
-The Army Medical Service plays a vital role in military operations. It provides medical support to troops in the field, operates field hospitals, and coordinates medical evacuations. The service also plays a key role in disaster relief operations, providing medical care to those affected by natural disasters and other emergencies.
+== Gallery ==
+<gallery>
+File:Autorecessive.svg|Inheritance pattern of autosomal recessive disorders
+</gallery>
-== See Also ==
+[[Category:Genetic disorders]]
+[[Category:Endocrine diseases]]
-* [[Military medicine]]
-* [[German Armed Forces]]
-* [[Napoleonic Wars]]
-[[Category:Medical Services]]
-[[Category:German Armed Forces]]
-[[Category:Military Medicine]]
-{{medicine-stub}}