title: Effect of uni-adrenalectomy on blood pressure in a patient with excessive adrenal 18-hydroxy-11-deoxycorticosterone production bilaterally.
abstract: A 46-year-old woman was presented with mineralocorticoid excess syndrome and a large mass originating from the right adrenal gland. Clinical examination before right adrenalectomy revealed elevated serum concentrations of 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) both systemically and in the adrenal veins bilaterally. Histopathological and immunohistochemical analyses of the surgical specimen demonstrated adrenal hyperplasia of outer fasciculata cells, and the presence of cystic mass. The adrenalectomy ameliorated her blood pressure (BP) from 156/96 mmHg to 148/87 mmHg with a concomitant increase of serum potassium concentration from 3.1 mEq/l to 3.5 mEq/l. These results suggest that uni-adrenalectomy is, at least in part, effective in ameliorating not only BP but also potassium concentration in a patient of adrenal hyperplasia with excessive bilateral 18-OH-DOC production.
authors.affiliation: Department of General Internal Medicine, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka 020-0066.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kawamura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Owada
authors.forename: Jun
authors.initials: J
authors.lastname: Ino
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugawara
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakano
authors.forename: Izumi
authors.initials: I
authors.lastname: Mochizuki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sakuma
authors.forename: Toshie
authors.initials: T
authors.lastname: Segawa
authors.forename: Itaru
authors.initials: I
authors.lastname: Motegi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
mesh_terms: D015070:18-Hydroxydesoxycorticosterone / Q000097:blood / Q000378:metabolism*; D000311:Adrenal Glands / Q000473:pathology* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D001707:Biopsy, Needle; D001795:Blood Pressure Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000473:pathology / Q000601:surgery; D006973:Hypertension / Q000175:diagnosis; D007150:Immunohistochemistry; D007564:Japan; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015070:18-Hydroxydesoxycorticosterone; D011188:Potassium