Bilateral Deoxycorticosterone‐Secreting Adrenocortical Adenoma

Nitta, Toshikazu; Kumamoto, Yoshiaki; Itoh, Naoki; Tachiki, Hitoshi; Mikuma, Naohito; Tsukamoto, Taiji; Ito, Osamu; Shimamoto, Kazuaki

doi:10.1111/j.1442-2042.1996.tb00583.x

Cited by 4 publications

(1 citation statement)

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“…Our case report shows several singularities. One was the suddenness of the life-threatening clinical presentation that took the patient to the ICU in less than a month since high BP was detected, while most of the previously published cases presented months or years before diagnosis ( 16 , 20 , 31 , 32 , 34 , 39 , 40 , 43 ). Additionally, initial serum hypokalemia was resistant despite high intravenous and oral K + supplements, leading to the suspicion of an underlying psychiatric disorder despite not having any previous history of mental diseases.…”

Section: Discussionmentioning

confidence: 99%

11-Deoxycorticosterone Producing Adrenal Hyperplasia as a Very Unusual Cause of Endocrine Hypertension: Case Report and Systematic Review of the Literature

et al. 2022

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Background and Objectives11-deoxycorticosterone overproduction due to an adrenal tumor or hyperplasia is a very rare cause of mineralocorticoid-induced hypertension. The objective is to provide the most relevant clinical features that clinicians dealing with patients presenting with the hallmarks of hypertension due to 11-deoxycorticosterone-producing adrenal lesions should be aware of.Design and MethodsWe report the case of a patient with an 11-deoxycorticosterone-producing adrenal lesion and provide a systematic review of all published cases (PubMed, Web of Science and EMBASE) between 1965 and 2021.ResultsWe identified 46 cases (including ours). Most cases (31, 67%) affected women with a mean age of 42.9 ± 15.2 years and presented with high blood pressure and hypokalemia (average of 2.68 ± 0.62 mmol/L). Median (interquartile range) time from onset of first suggestive symptoms to diagnosis was 24 (55) months. Aldosterone levels were low or in the reference range in 98% of the cases when available. 11-deoxycorticosterone levels were a median of 12.5 (18.9) times above the upper limit of the normal reference range reported in each article and overproduction of more than one hormone was seen in 31 (67%). Carcinoma was the most common histological type (21, 45.7%). Median tumor size was 61.5 (60) mm. Malignant lesions were larger, had higher 11-deoxycorticosterone levels and shorter time of evolution at diagnosis compared to benign lesions.Conclusions11-deoxycorticosterone-producing adrenal lesions are very rare, affecting mostly middle-aged women with a primary aldosteronism-like clinical presentation and carcinoma is the most frequent histological diagnosis. Measuring 11-deoxycorticosterone levels, when low aldosterone levels or in the lower limit of the reference range are present in hypertensive patients, is advisable.Systematic Review RegistrationOpen Science Framework, 10.17605/OSF.IO/NR7UV.

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