title: Primary aldosteronism combined with preclinical Cushing's syndrome in an elderly patient.
abstract: 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.
authors.affiliation: Division of Hypertension and Nephrology, National Cardiovascular Center, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Kei
authors.initials: K
authors.lastname: Kamide
authors.forename: Osamu
authors.initials: O
authors.lastname: Miyake
authors.forename: Toyofumi
authors.initials: T
authors.lastname: Abe
authors.forename: Michiko
authors.initials: M
authors.lastname: Nagai
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakahama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Horio
authors.forename: Shin
authors.initials: S
authors.lastname: Takiuchi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
authors.forename: Chikao
authors.initials: C
authors.lastname: Yutani
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
mesh_terms: 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
chemical_list: D000450:Aldosterone; D019405:Cytochrome P-450 CYP11B2; D006854:Hydrocortisone