title: Hyper-responsiveness of adrenal gland to vasopressin resulting in enhanced plasma cortisol in patients with adrenal nodule(s).
abstract: Hyper-responsiveness of plasma cortisol to vasopressin has been demonstrated in ACTH-independent bilateral macronodular adrenocortical hyperplasia (AIMAH) and some adrenal adenomas with Cushing's syndrome (CS). However, the clinical significance of hyper-responsiveness of plasma cortisol to vasopressin has not been investigated systematically in adrenal nodule(s). The aim of this study was to clarify the prevalence of hyper-responsiveness of plasma cortisol to vasopressin (vasopressin responder) and their clinical characteristics in terms of hormonal secretion using vasopressin-loading test in the patients with adrenal nodule(s) except pheochromocytomas. A vasopressin-loading test was performed on 61 consecutive patients with adrenal nodules (CS: 33, aldosterone-producing adenoma: 10, non-functional tumor: 18). Vasopressin responders were observed in 36.1% of adrenal nodule(s), 42.4% of CS and 28.5% of non-CS. In responders with CS, eight patients had bilateral nodules that were diagnosed as AIMAH, and the remaining six patients had a unilateral nodule. These patients had lower plasma cortisol than non-responders at both morning (P<0.01) and midnight (P<0.05), as well as the morning following overnight dexamethasone suppression at 1mg (P<0.05) and 8mg (P<0.05). Hyper-responsiveness of the adrenal gland to vasopressin resulting in enhanced plasma cortisol was frequently observed among patients with adrenal nodule(s). The vasopressin responders among the patients with adrenal nodule(s) frequently had CS with low autonomous cortisol secretion.
authors.affiliation: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Suzuki
authors.forename: Daigaku
authors.initials: D
authors.lastname: Uchida
authors.forename: Hisashi
authors.initials: H
authors.lastname: Koide
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Noguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tatsuno
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000378:metabolism* / Q000473:pathology; D000311:Adrenal Glands / Q000187:drug effects / Q000473:pathology; D000328:Adult; D000368:Aged; D003480:Cushing Syndrome / Q000097:blood / Q000503:physiopathology; D003907:Dexamethasone / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014667:Vasopressins / Q000494:pharmacology*
chemical_list: D005938:Glucocorticoids; D014667:Vasopressins; D003907:Dexamethasone; D006854:Hydrocortisone