Decreased dehydroepiandrosterone sulfate in pigmented nodular adrenal dysplasia.
Previous reports on patients with endogenous Cushing's syndrome describe low concentrations of the adrenal androgen dehydroepiandrosterone sulfate (DHEA-S) in adrenal adenoma and in a case of feminizing macronodular hyperplasia. Here we present hormonal data from two adult sisters with Cushing's syndrome as a result of pigmented nodular adrenal dysplasia. Corticotropin concentrations were in the mid-normal range, cortisol production was unaffected by administration of dexamethasone (8 mg/24 h), and baseline concentrations of DHEA-S were less than 0.5 mumol/L. A low concentration of DHEA-S in these and other previously reported patients with Cushing's syndrome correctly predicts the results of dynamic testing. Decreased DHEA-S in a patient with endogenous Cushing's syndrome can be ascertained by assay of a single sample and should prompt consideration of the diagnosis of autonomous bilateral nodular disease as well as adrenal adenoma.
Braithwaite
S S
SS
Department of Medicine, Loyola University Stritch School of Medicine, Maywood, IL 60153.
Collins
S
S
Prinz
R A
RA
Walloch
J L
JL
Winters
G L
GL
D000311:Adrenal Glands / Q000473:pathology*; D000328:Adult; D003480:Cushing Syndrome / Q000097:blood* / Q000473:pathology; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives* / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D005260:Female; D006801:Humans
D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate