Increased urinary cortisol and androgen metabolites in a young female with hypertension: partial glucocorticoid resistance syndrome.
A 21-year-old woman with hypertension confirmed on ambulatory blood pressure monitoring and unresponsive to beta-blockers, diltiazem and amiloride was found to have serum potassium, renin and aldosterone levels at or just below the lower end of normal. Urinary glucocorticoid metabolite analysis revealed high excretion of cortisol and androgen metabolites, with normal serum cortisol levels. This pattern suggests a partial glucocorticoid resistance syndrome; such patients are more responsive to ACE inhibitors and spironolactone.
Shamim
W
W
National Heart and Lung Institute, Royal Brompton and Harefield NHS Trust, London (UK). w-shamim@excite.com
Bakhai
A
A
Yousufuddin
M
M
Coats
A J
AJ
D000328:Adult; D000728:Androgens / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005938:Glucocorticoids / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D006973:Hypertension / Q000503:physiopathology / Q000652:urine*; D013577:Syndrome
D000728:Androgens; D015415:Biomarkers; D005938:Glucocorticoids; D006854:Hydrocortisone