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J Endocrinol Invest. 2013 Sep;36(8):564-7. doi: 10.3275/8818. Epub 2013 Feb 4.

Primary aldosteronism associated with subclinical Cushing syndrome.

Author information

1
Center for Diabetes and Endocrinology, Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital, 2-4-20 Ohgimachi Kita-ku, Osaka, 530-8480, Japan.

Abstract

BACKGROUND:

Recently, it has been reported that the incidence of primary aldosteronism (PA) among patients with hypertension is much more frequent than previously reported.

AIM:

In the present study, we investigated the frequency and features of PA associated with subclinical Cushing syndrome (SCS).

MATERIAL AND METHODS:

Subjects included consecutive patients (no.=39) who were diagnosed as PA and performed adrenal venous sampling between 2003 and 2011 in our institute.

RESULTS:

In 39 subjects who were diagnosed as PA, 29 patients were operated and 5 cases (12.8%) showed no suppression in low-dose dexamethasone suppression test. Four cases of them were demonstrated to be associated with SCS, and one was associated with overt Cushing syndrome (CS). Post-operatively, 3 cases received replacement therapy of hydrocortisone, while others did not. Pathological findings indicated the diagnosis of aldosterone-producing adenoma in 4 cases associated with SCS, and of idiopathic hyperaldosteronismin in one case associated with overt CS. In all 5 cases, immunohistochemical analysis demonstrated the immunoreactivities of both 3╬▓HSD and P450c17 in the adrenocortical tumors, the marked cortical atrophy in the zona fasciculata and reticularis, the decreased dehydroepiandrosterone sulfotransferase expression, and suppression of hypothalamo- pituitary-adrenal axis indicating the autonomous secretion of cortisol from the tumor.

CONCLUSIONS:

The present study suggests that PA is frequently associated with SCS with prevalence of more than 10%, justifying the routine examinations for SCS in PA cases.

PMID:
23385627
DOI:
10.3275/8818
[Indexed for MEDLINE]

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