Acth-independent Cushing's syndrome: bilateral cortisol-producing adrenal adenomas.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
S F DinneenW F Young

Abstract

ACTH-independent Cushing's syndrome (CS) usually results from a solitary adrenocortical adenoma. We recently encountered a patient with ACTH-independent CS associated with bilateral adrenal enlargement. The evaluation led us to consider some rare but interesting entities. The patient was a 69 year-old woman who had a 10-15 year history of controlled hypertension, back pain associated with osteoporosis, easy bruising, and truncal obesity. Her medications included conjugated estrogens. Physical examination revealed classical features of CS. She had a raised blue lesion on her buccal mucosa. Plasma cortisol concentrations were elevated at 36 (a.m.) and 38 (p.m.) microg/dL. Urinary free cortisol was normal at baseline (65 microg/24 hours) but failed to suppress adequately in response to the low-dose dexamethasone suppression test (75 microg/24 hours). The plasma ACTH concentration was undetectable. Plasma cortisol concentrations failed to suppress (37 microg/dL) with an 8 mg overnight dexamethasone test. A CT scan of the abdomen revealed bilateral adrenal masses. The possibilities of food-induced CS and primary pigmented nodular adrenal disease were excluded by a lack of marked stimulation in cortisol secretion to a mixed-meal and ...Continue Reading

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Citations

Mar 10, 2015·European Journal of Endocrinology·Anne ThielUte I Scholl
Jan 23, 2008·Arquivos brasileiros de endocrinologia e metabologia·Anju SahdevAshley B Grossman
Jan 8, 2003·Nursing Administration Quarterly·Patricia T AlpertLori Candela
Sep 18, 2002·Journal for Nurses in Staff Development : JNSD : Official Journal of the National Nursing Staff Development Organization·Lisa Perla
Jan 23, 2002·The Journal of Nursing Administration·Joanne Ritter-Teitel
Dec 20, 2013·Journal of Physics. Condensed Matter : an Institute of Physics Journal·Berk Onat, Sondan Durukanoğlu
Sep 18, 2012·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Raquel G MartinsMaralyn R Druce

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