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

DOI Web Site 参考文献23件
  • Kukidome Daisuke
    Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan
  • Miyamura Nobuhiro
    Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan
  • Sakakida Kourin
    Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan
  • Shimoda Seiya
    Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan
  • Shigematu Yoshinori
    Department of Diagnostic Imaging, Faculty of Life Sciences, Kumamoto University, Japan
  • Nishi Kazuhiko
    Department of Urology, Faculty of Life Sciences, Kumamoto University, Japan
  • Yamashita Yasuyuki
    Department of Diagnostic Imaging, Faculty of Life Sciences, Kumamoto University, Japan
  • Eto Masatoshi
    Department of Urology, Faculty of Life Sciences, Kumamoto University, Japan
  • Sasano Hironobu
    Department of Pathology, Tohoku University School of Medicine, Japan
  • Araki Eiichi
    Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan

抄録

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.<br>

収録刊行物

  • Internal Medicine

    Internal Medicine 51 (4), 395-400, 2012

    一般社団法人 日本内科学会

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