Clinical characterization of patients with primary aldosteronism plus subclinical Cushing’s syndrome

Yasuda, Shinichi; Hikima, Yusuke; Kabeya, Yusuke; Iida, Shinichiro; Oikawa, Yoichi; Isshiki, Masashi; Inoue, Ituro; Shimada, Akira; Noda, Mitsuhiko

doi:10.1186/s12902-020-0490-0

Cited by 14 publications

(14 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SCS is generally found when a patient with an unidentified adrenal mass underwent DMST, and it is the most common endocrine syndrome associated with an adrenal adenoma ( 22 , 24 ). Many cases of PA with SCS have been reported as aldosterone/cortisol cosecreting adenomas ( 6 ). Both overt and subclinical Cushing's syndrome develop hypertension, dyslipidemia, insulin resistance and T 2 DM.…”

Section: Discussionmentioning

confidence: 99%

“…SCS could cause hypertension, insulin resistance, and dyslipidemia ( 5 ). The coexisting PA and SCS are associated with increased cardiovascular morbidity and mortality ( 6 ). Previous studies have shown that the incidences of coexistent PA and SCS range between approximately 10 and 20% ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…The coexisting PA and SCS are associated with increased cardiovascular morbidity and mortality ( 6 ). Previous studies have shown that the incidences of coexistent PA and SCS range between approximately 10 and 20% ( 6 ). Most of these patients had adenomas that secreted both cortisol and aldosterone simultaneously, i.e., aldosterone- and cortisol-cosecreting adrenal tumors ( 7 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Case Report: Primary Aldosteronism and Subclinical Cushing Syndrome in a 49-Year-Old Woman With Hypertension Plus Hypokalaemia

Ji²,

Tao³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundCoexisting primary aldosteronism (PA) and subclinical Cushing's syndrome (SCS) caused by bilateral adrenocortical adenomas have occasionally been reported. Precise diagnosis and treatment of the disease pose a challenge to clinicians due to its atypical clinical manifestations and laboratory findings.Case SummaryA 49-year-old woman was admitted to our hospital due to fatigue, increased nocturia and refractory hypertension. The patient had a history of severe left hydronephrosis 6 months prior. Laboratory examinations showed hypokalaemia (2.58 mmol/L) and high urine potassium (71 mmol/24 h). Adrenal computed tomography (CT) showed bilateral adrenal masses. Undetectable ACTH and unsuppressed plasma cortisol levels by dexamethasone indicated ACTH-independent Cushing's syndrome. Although the upright aldosterone-to-renin ratio (ARR) was 3.06 which did not exceed 3.7, elevated plasma aldosterone concentrations (PAC) with unsuppressed PAC after the captopril test still suggested PA. Adrenal venous sampling (AVS) without adrenocorticotropic hormone further revealed hypersecretion of aldosterone from the right side and no dominant side of cortisol secretion. A laparoscopic right adrenal tumor resection was performed. The pathological diagnosis was adrenocortical adenoma. After the operation, the supine and standing PAC were normalized; while the plasma cortisol levels postoperatively were still high and plasma renin was activated. The patient's postoperative serum potassium and 24-h urine potassium returned to normal without any pharmacological treatment. In addition, the patient's blood pressure was controlled normally with irbesartan alone.ConclusionPatients with refractory hypertension should be screened for the cause of secondary hypertension. AVS should be performed in patients in which PA is highly suspected to determine whether there is the option of surgical treatment. Moreover, patients with PA should be screened for hypercortisolism, which can contribute to a proper understanding of the AVS result.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Case Report: Primary Aldosteronism and Subclinical Cushing Syndrome in a 49-Year-Old Woman With Hypertension Plus Hypokalaemia

Ji²,

Tao³

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…The size of the aldosterone‐producing adenoma matters for the identification of subclinical Cushing's syndrome 9,10 . Such patients all had large (2.0‐2.5 cm in diameter) adenomas, minimally 1.1 cm 12 . Adenomas are usually in a single neoplasm that secrets both aldosterone and cortisol, but can also be in two different neoplasms, either ipsilateral or contralateral, that secret aldosterone and cortisol, respectively 9 .…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Such patients all had large (2.0‐2.5 cm in diameter) adenomas, minimally 1.1 cm. 12 Adenomas are usually in a single neoplasm that secrets both aldosterone and cortisol, but can also be in two different neoplasms, either ipsilateral or contralateral, that secret aldosterone and cortisol, respectively. 9 If the diameter of the aldosterone‐producing adenoma is 2.0‐2.5 cm, subclinical Cushing's syndrome has to be considered.…”

Section: Discussionmentioning

confidence: 99%

Hypertension with unilateral adrenal aldosterone and cortisol cosecreting adenoma: A case report

Chen

Shao

et al. 2021

J of Clinical Hypertension

View full text Add to dashboard Cite

Here, we report a case of unilateral adrenal aldosterone and cortisol co-secreting adenoma. A 34-year-old man with a history of severe hypertension for one year was detected hypokalemia (2.42 mmol/L lowest) and unilateral adrenal mass in a size of 71 mm*63 mm. Measurements of plasma aldosterone concentration and plasma renin activity showed marked increases. Primary aldosteronism was diagnosed. To exclude adrenal malignancy, the function of zona fasciculate was evaluated, and 24-h urine free cortisol was found abnormal in a testing. Further examinations revealed that circadian rhythm of serum cortisol disappeared and 2 mg-dexamethasone suppression test was positive. The final diagnosis was secondary hypertension, primary aldosteronism and subclinical Cushing's syndrome. After unilateral adrenalectomy, his blood pressure was normalized and biochemical parameters in the normal range. In conclusion, in patients with a large aldosterone-producing adenoma, the function of zona fasciculate might have to be evaluated for the identification of aldosterone and cortisol co-secreting neoplasms.

show abstract

Postoperative adrenal insufficiency in Conn’s syndrome—does it occur frequently?

et al. 2021

View full text Add to dashboard Cite

Clinical characterization of patients with primary aldosteronism plus subclinical Cushing’s syndrome

Cited by 14 publications

References 43 publications

Case Report: Primary Aldosteronism and Subclinical Cushing Syndrome in a 49-Year-Old Woman With Hypertension Plus Hypokalaemia

Case Report: Primary Aldosteronism and Subclinical Cushing Syndrome in a 49-Year-Old Woman With Hypertension Plus Hypokalaemia

Hypertension with unilateral adrenal aldosterone and cortisol cosecreting adenoma: A case report

Postoperative adrenal insufficiency in Conn’s syndrome—does it occur frequently?

Contact Info

Product

Resources

About