title: Macronodular adrenocortical hyperplasia in a postmenopausal woman.
abstract: This case report describes the diagnosis of Cushing's syndrome due to macronodular adrenal hyperplasia in an elderly woman who presented with fatigue, muscle weakness and oedema, and recent excessive bruising. Long-standing disease and comorbidity precluded adrenalectomy. Despite treatment with metyrapone and diuretics, the patient died after two months hospitalisation. Postmortal examination revealed overexpression of luteinising hormone (LH) receptors in the adrenal glands, suggesting that the postmenopausal rise in LH may have a role in adrenal hyperplasia and hypercortisolism.
authors.affiliation: Department of Internal Medicine, Free University Medical Centre, Amsterdam, The Netherlands. gs.mijnhout@vumc.nl
authors.forename: G S
authors.initials: GS
authors.lastname: Mijnhout
authors.forename: S A
authors.initials: SA
authors.lastname: Danner
authors.forename: F R W
authors.initials: FR
authors.lastname: van de Goot
authors.forename: E W C M
authors.initials: EW
authors.lastname: van Dam
mesh_terms: D000302:Adrenal Cortex / Q000473:pathology*; D000308:Adrenocortical Hyperfunction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D000368:Aged; D005260:Female; D006801:Humans; D006965:Hyperplasia; D047748:Pituitary ACTH Hypersecretion / Q000209:etiology