title: [Clinical characteristics of adrenocorticotropic hormone independent macronodular adrenal hyperplasia: a report of 30 cases].
abstract: OBJECTIVE
  To explore the clinical characteristics of adrenocorticotropic hormone (ACTH) independent macronodular adrenal hyperplasia (AIMAH).
  
  
  METHODS
  A total of 30 AIMAH patients from January 2001 to December 2011 at our hospital were reviewed retrospectively and their clinical data collected.
  
  
  RESULTS
  AIMAH was equally distributed between genders. Their mean age was 44 ± 9 years and median course of disease 5 years. Hypertension was the most common clinical manifestation. Circadian rhythm of plasma cortisol disappeared in all patients, and the level of 24 hour urinary free cortisol (24 hUFC) was normal only in 4 (13.3%) patients. Both low and high dose dexamethasone suppression tests were not suppressed in 30 (100.0%) and 28 (93.3%) patients respectively. The stimulation tests for detecting aberrant expression of hormone receptors were performed in 14 patients. At least one aberrant cortisol response was identified in 12 patients. Twenty-five patients underwent adrenalectomy. Among 7 patients of bilateral adrenalectomy, 6 achieved remission while 8 patients did so among 14 patients of unilateral adrenalectomy.
  
  
  CONCLUSIONS
  AIMAH should be considered in patients with massively enlarged bilateral adrenal glands. Treatment modalities should be decided according to clinical manifestations and cortisol level so as to relieve symptoms and improve prognosis.
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Lian
authors.initials: L
authors.lastname: Duan
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China. Email: lulin88@sina.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Zhaolin
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Feng
authors.initials: F
authors.lastname: Gu
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Hu
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Anli
authors.initials: A
authors.lastname: Tong
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Hanzhong
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730 , China.
authors.forename: Xuebin
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000303:Adrenal Cortex Diseases / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D000324:Adrenocorticotropic Hormone; D000328:Adult; D000368:Aged; D003480:Cushing Syndrome / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000324:Adrenocorticotropic Hormone