title: Primary aldosteronism associated with subclinical Cushing syndrome.
abstract: BACKGROUND
  Recently, it has been reported that the incidence of primary aldosteronism (PA) among patients with hypertension is much more frequent than previously reported.
  
  
  OBJECTIVE
  In the present study, we investigated the frequency and features of PA associated with subclinical Cushing syndrome (SCS).
  
  
  METHODS
  Subjects included consecutive patients (no.=39) who were diagnosed as PA and performed adrenal venous sampling between 2003 and 2011 in our institute.
  
  
  RESULTS
  In 39 subjects who were diagnosed as PA, 29 patients were operated and 5 cases (12.8%) showed no suppression in low-dose dexamethasone suppression test. Four cases of them were demonstrated to be associated with SCS, and one was associated with overt Cushing syndrome (CS). Post-operatively, 3 cases received replacement therapy of hydrocortisone, while others did not. Pathological findings indicated the diagnosis of aldosterone-producing adenoma in 4 cases associated with SCS, and of idiopathic hyperaldosteronismin in one case associated with overt CS. In all 5 cases, immunohistochemical analysis demonstrated the immunoreactivities of both 3βHSD and P450c17 in the adrenocortical tumors, the marked cortical atrophy in the zona fasciculata and reticularis, the decreased dehydroepiandrosterone sulfotransferase expression, and suppression of hypothalamo- pituitary-adrenal axis indicating the autonomous secretion of cortisol from the tumor.
  
  
  CONCLUSIONS
  The present study suggests that PA is frequently associated with SCS with prevalence of more than 10%, justifying the routine examinations for SCS in PA cases.
authors: Center for Diabetes and Endocrinology, Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital, 2-4-20 Ohgimachi Kita-ku, Osaka, 530-8480, Japan.
authors: K
authors: K
authors: Fujimoto
authors: S
authors: S
authors: Honjo
authors: H
authors: H
authors: Tatsuoka
authors: Y
authors: Y
authors: Hamamoto
authors: Y
authors: Y
authors: Kawasaki
authors: A
authors: A
authors: Matsuoka
authors: H
authors: H
authors: Ikeda
authors: Y
authors: Y
authors: Wada
authors: H
authors: H
authors: Sasano
authors: H
authors: H
authors: Koshiyama
mesh_terms: D000236:Adenoma / Q000175:diagnosis; D000306:Adrenal Cortex Neoplasms / Q000150:complications*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis; D000328:Adult; D003480:Cushing Syndrome / Q000150:complications*; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006929:Hyperaldosteronism / Q000209:etiology*; D008297:Male; D008875:Middle Aged
chemical_list: D003907:Dexamethasone; D006854:Hydrocortisone
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