Apparent mineralocorticoid excess syndrome Apparent mineralocorticoid excess syndrome Apparent mineralocorticoid excess (AME) is an autosomal recessive disorder causing hypertension (high blood pressure) and hypokalemia (abnormally low levels of potassium). It was found by Dr Maria I. New at Weil Cornell Hospital in New York City. It results from mutations in the "HSD11B2" gene, which encodes the kidney isozyme of 11β-hydroxysteroid dehydrogenase type 2. 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 aldosterone sensitive tissues like the kidney. Cortisol at high concentrations can cross-react and activate
Base excess data. The term and concept of base excess were first introduced by Poul Astrup and Ole Siggaard-Andersen in 1958. Base excess can be estimated from the bicarbonate concentration ([HCO]) and pH by the equation: formula_1 with units of mEq/L. The same can be alternatively expressed as formula_2 Calculations are based on the Henderson-Hasselbalch equation: Ultimately the end result is: Base excess beyond the reference range indicates Blood pH is determined by both a metabolic component, measured by base excess, and a respiratory component, measured by PaCO (partial pressure of carbon dioxide). Often a disturbance in one triggers a partial compensation