Intraadrenal Corticotropin in Bilateral Macronodular Adrenal Hyperplasia

This study showed that cortisol secretion by the adrenals in patients with macronodular hyperplasia is probably regulated by corticotropin produced within the adrenals. Thus, hypercortisolism associated with this form of adrenal hyperplasia is probably corticotropin-dependent. Chronic excess of glucocorticoids may lead to a constellation of symptoms that include central obesity and arterial hypertension, termed Cushing's syndrome, which is associated with increased mortality. In 10 to 20% of cases, Cushing's syndrome is caused by primary adrenal cortisol hypersecretion. 1 Among patients with primary hypersecretion of adrenal cortisol, bilateral macronodular adrenal disease is extremely rare, representing less than 2% of all cases of Cushing's syndrome. Hypersecretion of cortisol by the enlarged adrenal glands suppresses the release of corticotropin by the anterior pituitary, leading to low plasma levels of corticotropin. For this reason, the disease has also been called . . .