Mineralocorticoids is a class of steroids characterised by their similarity to aldosterone and their influence on salt and water metabolism.
The only endogenous mineralocorticoid is aldosterone, although a number of hormones (mainly progesterone) have mineralocorticoid function. An example of synthetic mineralocorticoids is fludrocortisone (Florinef®). An important mineralocorticoid inhibitor is spironolactone.
Aldosterone acts on sweat glands to reduce sodium loss in sweat and also acts on taste buds to sharpen the taste.
The mineralocorticoid effect differs: hypertension is usually the clinical clue that a patient has 11- rather than 21-hydroxylase CAH.
Mineralocorticoid manifestations of severe 11β-hydroxylase deficient CAH can be biphasic, changing from deficiency (salt-wasting) in early infancy to excess (hypertension) in childhood and adult life.
DOC is a weak mineralocorticoid, but usually reaches high enough levels in this disease to cause effects of mineralocorticoid excess: salt retention, volume expansion, and hypertension.
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