Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Preclinical Cushing's Syndrome Due to ACTH-independent Bilateral Macronodular Adrenocortical Hyperplasia with Excessive Secretion of 18-hydroxydeoxycorticosterone and Corticosterone
Seiki WADAShinji KITAHAMAAtsuhito TOGASHIKiyoaki INOUEMakoto IITAKAShigehiro KATAYAMA
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2002 Volume 41 Issue 4 Pages 304-308

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Abstract

A 64-year-old woman developed hypertension and hypokalemia, due to ACTH-independent bilateral macronodular adrenocortical hyperplasia (AIMAH) with excessive secretion of 18-hydroxydeoxycorticosterone and corticosterone. Plasma cortisol did not show a diurnal rhythm, and was not suppressed by dexamethasone (8 mg). Plasma cortisol responded to ACTH and was increased by hypoglycemia without modifying ACTH levels. Radiological studies demonstrated that adrenal glands were enlarged with macronodules. Although the patient exhibited a low plasma renin activity and aldosterone levels, hypokalemia and hypertension were observed. Hormonal findings would support the hypothesis that the tumor of AIMAH originated from cells of the upper zona fasciculata.
(Internal Medicine 41: 304-308, 2002)

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