Primary aldosteronism combined with preclinical Cushing's syndrome in an elderly patient.
Pre-clinical Cushing's syndrome (pre-CS) is sometimes seen with adrenal cortical tumors. An 80-year-old woman had severe hypertension and hypokalemia, the typical clinical features of primary aldosteronism, but detailed hormonal examinations revealed the accompanying pre-CS. After adrenalectomy by laparoscopy, her blood pressure was remarkably reduced and the hypokalemia also recovered. The tumor consisted of mostly light clear cells and scattered dark compact cells resembling islands. Abundant expression of cytochrome P450 aldosterone synthase in the clear cells and cytochrome P450 11beta-hydroxylase in the dark cells was detected by immunohistochemical studies, which confirmed that clear cells can produce aldosterone and compact cells can produce cortisol.
Fujii
Hideki
H
Division of Hypertension and Nephrology, National Cardiovascular Center, Japan.
Kamide
Kei
K
Miyake
Osamu
O
Abe
Toyofumi
T
Nagai
Michiko
M
Nakahama
Hajime
H
Horio
Takeshi
T
Takiuchi
Shin
S
Okuyama
Akihiko
A
Yutani
Chikao
C
Kawano
Yuhei
Y
D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000378:metabolism / Q000628:therapy; D000311:Adrenal Glands / Q000378:metabolism; D000315:Adrenalectomy / Q000379:methods; D000369:Aged, 80 and over; D000450:Aldosterone / Q000378:metabolism; D003480:Cushing Syndrome / Q000150:complications / Q000378:metabolism / Q000628:therapy; D019405:Cytochrome P-450 CYP11B2 / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006929:Hyperaldosteronism / Q000150:complications / Q000378:metabolism / Q000628:therapy; D007008:Hypokalemia / Q000150:complications / Q000378:metabolism / Q000628:therapy
D000450:Aldosterone; D019405:Cytochrome P-450 CYP11B2; D006854:Hydrocortisone