A Case of Cortisol Producing Adrenal Adenoma Associated with a Latent Aldosteronoma: Usefulness of the ACTH Loading Test for the Detection of Covert Aldosteronism in Overt Cushing Syndrome
A 36-year-old woman with Cushing syndrome was evaluated for coexisting hyperaldosteronism, which was suggested by an abnormal response of the aldosterone-to-cortisol ratio in peripheral blood to the ACTH-administration despite a low basal aldosterone-to-renin ratio. Computed tomography revealed two...
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| Veröffentlicht in: | Internal Medicine 2012, Vol.51(4), pp.395-400 |
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| container_title | Internal Medicine |
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| creator | Kukidome, Daisuke Miyamura, Nobuhiro Sakakida, Kourin Shimoda, Seiya Shigematu, Yoshinori Nishi, Kazuhiko Yamashita, Yasuyuki Eto, Masatoshi Sasano, Hironobu Araki, Eiichi |
| description | A 36-year-old woman with Cushing syndrome was evaluated for coexisting hyperaldosteronism, which was suggested by an abnormal response of the aldosterone-to-cortisol ratio in peripheral blood to the ACTH-administration despite a low basal aldosterone-to-renin ratio. Computed tomography revealed two independent tumors in the left adrenal gland, and adrenal venous sampling indicated hyperaldosteronism in addition to hypercortisolism in the same side. Postsurgical study including immunohistochemical analysis of steroidogenic enzymes suggested one adenoma to be cortisol-producing and the other, aldosterone-producing. The comorbidity of these different hormone-producing adenomas is not rare and careful pre-surgical evaluation is necessary to avoid post-surgical exacerbation of latent hyperaldosteronism. |
| doi_str_mv | 10.2169/internalmedicine.51.5597 |
| format | Article |
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Computed tomography revealed two independent tumors in the left adrenal gland, and adrenal venous sampling indicated hyperaldosteronism in addition to hypercortisolism in the same side. Postsurgical study including immunohistochemical analysis of steroidogenic enzymes suggested one adenoma to be cortisol-producing and the other, aldosterone-producing. The comorbidity of these different hormone-producing adenomas is not rare and careful pre-surgical evaluation is necessary to avoid post-surgical exacerbation of latent hyperaldosteronism.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.51.5597</identifier><identifier>PMID: 22333376</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>ACTH loading test ; Adrenal Gland Neoplasms - complications ; Adrenal Gland Neoplasms - diagnosis ; Adrenalectomy ; Adrenocortical Adenoma - complications ; Adrenocortical Adenoma - diagnosis ; Adrenocorticotropic Hormone ; Adult ; Aldosterone - blood ; Cushing Syndrome - complications ; Cushing syndrome with latent hyperaldosteronism ; Female ; Humans ; Hydrocortisone - blood ; Hyperaldosteronism - diagnosis ; Hyperaldosteronism - etiology ; Tomography, X-Ray Computed</subject><ispartof>Internal Medicine, 2012, Vol.51(4), pp.395-400</ispartof><rights>2012 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c523t-c0a9a6e9d0096bc36ac4868b84e5d5b8cbcc1c8215fcb6f82244d8897edf483e3</citedby><cites>FETCH-LOGICAL-c523t-c0a9a6e9d0096bc36ac4868b84e5d5b8cbcc1c8215fcb6f82244d8897edf483e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22333376$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kukidome, Daisuke</creatorcontrib><creatorcontrib>Miyamura, Nobuhiro</creatorcontrib><creatorcontrib>Sakakida, Kourin</creatorcontrib><creatorcontrib>Shimoda, Seiya</creatorcontrib><creatorcontrib>Shigematu, Yoshinori</creatorcontrib><creatorcontrib>Nishi, Kazuhiko</creatorcontrib><creatorcontrib>Yamashita, Yasuyuki</creatorcontrib><creatorcontrib>Eto, Masatoshi</creatorcontrib><creatorcontrib>Sasano, Hironobu</creatorcontrib><creatorcontrib>Araki, Eiichi</creatorcontrib><title>A Case of Cortisol Producing Adrenal Adenoma Associated with a Latent Aldosteronoma: Usefulness of the ACTH Loading Test for the Detection of Covert Aldosteronism in Overt Cushing Syndrome</title><title>Internal Medicine</title><addtitle>Intern. 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The comorbidity of these different hormone-producing adenomas is not rare and careful pre-surgical evaluation is necessary to avoid post-surgical exacerbation of latent hyperaldosteronism.</description><subject>ACTH loading test</subject><subject>Adrenal Gland Neoplasms - complications</subject><subject>Adrenal Gland Neoplasms - diagnosis</subject><subject>Adrenalectomy</subject><subject>Adrenocortical Adenoma - complications</subject><subject>Adrenocortical Adenoma - diagnosis</subject><subject>Adrenocorticotropic Hormone</subject><subject>Adult</subject><subject>Aldosterone - blood</subject><subject>Cushing Syndrome - complications</subject><subject>Cushing syndrome with latent hyperaldosteronism</subject><subject>Female</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hyperaldosteronism - diagnosis</subject><subject>Hyperaldosteronism - etiology</subject><subject>Tomography, X-Ray Computed</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkcFu1DAQhiMEokvhFZBvnLLEdpzY3KIALVKkIrE9R4496bpK7GI7RX03Hq5OU1YI4cOMxvPNPyP9WYZwsSe4Eh-NjeCtnGbQRhkLe4b3jIn6RbbDtBR5TSh7me0KgXlOUjjL3oRwWxSU14K8zs4IoenV1S773aBWBkBuRK3z0QQ3oe_e6SXJ3qBGe0hrUgbrZomaEJwyMoJGv0w8Iom6VNiImkm7kG5yK_YJXQcYl8lCCKtwPAJq2sMl6pzUq-wBQkSj80-dzxBBRePsdsM9-L_lTJiRsejq6btdwnGd__FgtXczvM1ejXIK8O45n2fXX78c2su8u7r41jZdrhihMVeFFLICoYtCVIOilVQlr_jAS2CaDVwNSmHFCWajGqqRE1KWmnNRgx5LToGeZx823Tvvfi7p-H42QcE0SQtuCb0guMaiwiKRfCOVdyF4GPs7b2bpH3pc9Kt1_b_W9Qz3q3Vp9P3zkmVIzdPgH68S0G3AbYjyBk6ATLapCf6rXG6BCnbC1FH6Hix9BEOtusI</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>Kukidome, Daisuke</creator><creator>Miyamura, Nobuhiro</creator><creator>Sakakida, Kourin</creator><creator>Shimoda, Seiya</creator><creator>Shigematu, Yoshinori</creator><creator>Nishi, Kazuhiko</creator><creator>Yamashita, Yasuyuki</creator><creator>Eto, Masatoshi</creator><creator>Sasano, Hironobu</creator><creator>Araki, Eiichi</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120101</creationdate><title>A Case of Cortisol Producing Adrenal Adenoma Associated with a Latent Aldosteronoma: Usefulness of the ACTH Loading Test for the Detection of Covert Aldosteronism in Overt Cushing Syndrome</title><author>Kukidome, Daisuke ; Miyamura, Nobuhiro ; Sakakida, Kourin ; Shimoda, Seiya ; Shigematu, Yoshinori ; Nishi, Kazuhiko ; Yamashita, Yasuyuki ; Eto, Masatoshi ; Sasano, Hironobu ; Araki, Eiichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c523t-c0a9a6e9d0096bc36ac4868b84e5d5b8cbcc1c8215fcb6f82244d8897edf483e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>ACTH loading test</topic><topic>Adrenal Gland Neoplasms - complications</topic><topic>Adrenal Gland Neoplasms - diagnosis</topic><topic>Adrenalectomy</topic><topic>Adrenocortical Adenoma - complications</topic><topic>Adrenocortical Adenoma - diagnosis</topic><topic>Adrenocorticotropic Hormone</topic><topic>Adult</topic><topic>Aldosterone - blood</topic><topic>Cushing Syndrome - complications</topic><topic>Cushing syndrome with latent hyperaldosteronism</topic><topic>Female</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hyperaldosteronism - diagnosis</topic><topic>Hyperaldosteronism - etiology</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kukidome, Daisuke</creatorcontrib><creatorcontrib>Miyamura, Nobuhiro</creatorcontrib><creatorcontrib>Sakakida, Kourin</creatorcontrib><creatorcontrib>Shimoda, Seiya</creatorcontrib><creatorcontrib>Shigematu, Yoshinori</creatorcontrib><creatorcontrib>Nishi, Kazuhiko</creatorcontrib><creatorcontrib>Yamashita, Yasuyuki</creatorcontrib><creatorcontrib>Eto, Masatoshi</creatorcontrib><creatorcontrib>Sasano, Hironobu</creatorcontrib><creatorcontrib>Araki, Eiichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kukidome, Daisuke</au><au>Miyamura, Nobuhiro</au><au>Sakakida, Kourin</au><au>Shimoda, Seiya</au><au>Shigematu, Yoshinori</au><au>Nishi, Kazuhiko</au><au>Yamashita, Yasuyuki</au><au>Eto, Masatoshi</au><au>Sasano, Hironobu</au><au>Araki, Eiichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Case of Cortisol Producing Adrenal Adenoma Associated with a Latent Aldosteronoma: Usefulness of the ACTH Loading Test for the Detection of Covert Aldosteronism in Overt Cushing Syndrome</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. 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| ispartof | Internal Medicine, 2012, Vol.51(4), pp.395-400 |
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| language | eng |
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| subjects | ACTH loading test Adrenal Gland Neoplasms - complications Adrenal Gland Neoplasms - diagnosis Adrenalectomy Adrenocortical Adenoma - complications Adrenocortical Adenoma - diagnosis Adrenocorticotropic Hormone Adult Aldosterone - blood Cushing Syndrome - complications Cushing syndrome with latent hyperaldosteronism Female Humans Hydrocortisone - blood Hyperaldosteronism - diagnosis Hyperaldosteronism - etiology Tomography, X-Ray Computed |
| title | A Case of Cortisol Producing Adrenal Adenoma Associated with a Latent Aldosteronoma: Usefulness of the ACTH Loading Test for the Detection of Covert Aldosteronism in Overt Cushing Syndrome |
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