title: A marked difference in the vasopressin responsiveness between the adrenal glands in a patient with adrenocorticotropin-independent macronodular adrenal hyperplasia.
abstract: We herein present the case of a 53-year-old patient with adrenocorticotropin-independent macronodular adrenocortical hyperplasia (AIMAH), which is a rare form of Cushing syndrome. He had hypercortisolemia and bilateral macronodular adrenal glands with a left side predominance. The administration of vasopressin significantly increased the plasma cortisol level (1.9-fold). Following left adrenalectomy, the patient's hypercortisolemia significantly improved and vasopressin responsiveness was lost, suggesting that the responsiveness originated from the resected left adrenal gland. The marked difference in vasopressin responsiveness between the adrenals corresponded with their asymmetrical size and function. Evaluating the differences in the vasopressin sensitivity may therefore be helpful for understanding the progression of AIMAH.
authors.affiliation: Department of Endocrinology, Toyota Memorial Hospital, Japan.
authors.forename: Misaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Masanori
authors.initials: M
authors.lastname: Yoshida
authors.forename: Junji
authors.initials: J
authors.lastname: Shinoda
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oiso
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D000302:Adrenal Cortex / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D000306:Adrenal Cortex Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D003480:Cushing Syndrome / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D003894:Deamino Arginine Vasopressin; D003907:Dexamethasone; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology; D005951:Glucose Tolerance Test; D007987:Gonadotropin-Releasing Hormone; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D015228:Hypertriglyceridemia / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017483:Receptors, Vasopressin / Q000187:drug effects*; D013973:Thyrotropin-Releasing Hormone; D014667:Vasopressins / Q000494:pharmacology*
chemical_list: D017483:Receptors, Vasopressin; D014667:Vasopressins; D007987:Gonadotropin-Releasing Hormone; D013973:Thyrotropin-Releasing Hormone; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003894:Deamino Arginine Vasopressin; D006854:Hydrocortisone