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Adrenal venous sampling in a patient with adrenal Cushing syndrome.

Builes-Montaño CE, Villa-Franco CA, Román-Gonzalez A, Velez-Hoyos A, Echeverri-Isaza S - Colomb. Med. (2015)

Bottom Line: The primary bilateral macronodular adrenal hyperplasia or the independent adrenocorticotropic hormone bilateral nodular adrenal hyperplasia is a rare cause hypercortisolism, its diagnosis is challenging and there is no clear way to decide the best therapeutic approach.It could be a useful tool in this context because it might provide information to guide the treatment.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Médico Internista Endocrinólogo. Sección de Endocrinología, Departamento de Medicina Interna. Hospital Pablo Tobón Uribe - Universidad de Antioquia. Medellin, Colombia.

ABSTRACT
The primary bilateral macronodular adrenal hyperplasia or the independent adrenocorticotropic hormone bilateral nodular adrenal hyperplasia is a rare cause hypercortisolism, its diagnosis is challenging and there is no clear way to decide the best therapeutic approach. Adrenal venous sampling is commonly used to distinguish the source of hormonal production in patients with primary hyperaldosteronism. It could be a useful tool in this context because it might provide information to guide the treatment. We report the case of a patient with ACTH independent Cushing syndrome in whom the use of adrenal venous sampling with some modifications radically modified the treatment and allowed the diagnosis of a macronodular adrenal hyperplasia.

No MeSH data available.


Related in: MedlinePlus

Abdominal tomography. Right adrenal nodule 14x9 mm and left adrenal gland nodule 23x18 mm.
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f01: Abdominal tomography. Right adrenal nodule 14x9 mm and left adrenal gland nodule 23x18 mm.

Mentions: A 76 years-old woman with history of controlled hypertension (with losartan and amlodipine) presented to our hospital referring weight loss of 4 kg in two months, edema that progressed to anasarca and back lumbar pain. Besides the edema her physical examination was completely normal with no clinical signs suggestive of hypercortisolism. Among the studies requested, an abdominal tomography showed a right adrenal gland nodule of 14x9 mm and another one in the left adrenal gland of 23x18 mm (Fig. 1), additionally multiple vertebral fractures were reported. As part of the study of adrenal adenomas the patient had an abnormal value of cortisol after a low dose suppression test with dexamethasone (13.3 µg/dL (normal value: <1.8 µg/dL), with a normal value of free urinary cortisol and her potassium was low (she was not on diuretics). The results of the patient laboratory test are shown on Table 1.


Adrenal venous sampling in a patient with adrenal Cushing syndrome.

Builes-Montaño CE, Villa-Franco CA, Román-Gonzalez A, Velez-Hoyos A, Echeverri-Isaza S - Colomb. Med. (2015)

Abdominal tomography. Right adrenal nodule 14x9 mm and left adrenal gland nodule 23x18 mm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536821&req=5

f01: Abdominal tomography. Right adrenal nodule 14x9 mm and left adrenal gland nodule 23x18 mm.
Mentions: A 76 years-old woman with history of controlled hypertension (with losartan and amlodipine) presented to our hospital referring weight loss of 4 kg in two months, edema that progressed to anasarca and back lumbar pain. Besides the edema her physical examination was completely normal with no clinical signs suggestive of hypercortisolism. Among the studies requested, an abdominal tomography showed a right adrenal gland nodule of 14x9 mm and another one in the left adrenal gland of 23x18 mm (Fig. 1), additionally multiple vertebral fractures were reported. As part of the study of adrenal adenomas the patient had an abnormal value of cortisol after a low dose suppression test with dexamethasone (13.3 µg/dL (normal value: <1.8 µg/dL), with a normal value of free urinary cortisol and her potassium was low (she was not on diuretics). The results of the patient laboratory test are shown on Table 1.

Bottom Line: The primary bilateral macronodular adrenal hyperplasia or the independent adrenocorticotropic hormone bilateral nodular adrenal hyperplasia is a rare cause hypercortisolism, its diagnosis is challenging and there is no clear way to decide the best therapeutic approach.It could be a useful tool in this context because it might provide information to guide the treatment.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Médico Internista Endocrinólogo. Sección de Endocrinología, Departamento de Medicina Interna. Hospital Pablo Tobón Uribe - Universidad de Antioquia. Medellin, Colombia.

ABSTRACT
The primary bilateral macronodular adrenal hyperplasia or the independent adrenocorticotropic hormone bilateral nodular adrenal hyperplasia is a rare cause hypercortisolism, its diagnosis is challenging and there is no clear way to decide the best therapeutic approach. Adrenal venous sampling is commonly used to distinguish the source of hormonal production in patients with primary hyperaldosteronism. It could be a useful tool in this context because it might provide information to guide the treatment. We report the case of a patient with ACTH independent Cushing syndrome in whom the use of adrenal venous sampling with some modifications radically modified the treatment and allowed the diagnosis of a macronodular adrenal hyperplasia.

No MeSH data available.


Related in: MedlinePlus