Abstract | BACKGROUND: Incidentally discovered adrenal tumours are frequently associated with subclinical autonomous cortisol hypersecretion of unknown origin. Aberrant hormone receptors have been observed in case reports of overt Cushing's syndrome. The question arises as to whether such receptors may be present in the functioning adrenal incidentaloma, which is common and might be a subclinical stage of Cushing's syndrome. PATIENTS AND METHODS: RESULTS: The most constant responses in adrenal incidentalomas were observed after stimulation by terlipressin (18/20 patients, 28-415% cortisol increase) and cisapride (17/21 patients, 25-364% cortisol increase). Eighteen out of 21 patients responded to several stimuli ( cortisol increase >or= 25%), and all responded to at least one stimulus other than ACTH, while such responses were absent in the controls. Plasma ACTH remained suppressed in all subjects throughout the study. CONCLUSIONS: Aberrant membrane receptors detected by in vivo stimulation tests appear to be common in autonomously functioning unilateral adrenocortical adenomas. These receptors may be involved in the modulation of cortisol secretion in adrenal incidentaloma, with potential therapeutic consequences for the control of subclinical cortisol hypersecretion.
|
Authors | Y Reznik, H Lefebvre, V Rohmer, B Charbonnel, A Tabarin, P Rodien, P Lecomte, S Bardet, C Coffin, J Mahoudeau, REHOS study group |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 61
Issue 3
Pg. 311-9
(Sep 2004)
ISSN: 0300-0664 [Print] England |
PMID | 15355446
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Hypothalamic Hormones
- Serotonin Receptor Agonists
- Vasoconstrictor Agents
- Angiotensin II
- Lypressin
- Terlipressin
- Adrenocorticotropic Hormone
- Glucagon
- Cisapride
- Hydrocortisone
|
Topics |
- Adenoma
(blood, metabolism)
- Adrenal Gland Neoplasms
(blood, metabolism)
- Adrenocorticotropic Hormone
(blood)
- Adult
- Aged
- Angiotensin II
(administration & dosage)
- Case-Control Studies
- Cisapride
(administration & dosage)
- Eating
- Female
- Glucagon
(administration & dosage)
- Humans
- Hydrocortisone
(blood, metabolism)
- Hypothalamic Hormones
(administration & dosage)
- Incidental Findings
- Lypressin
(administration & dosage, analogs & derivatives)
- Male
- Middle Aged
- Posture
- Prospective Studies
- Serotonin Receptor Agonists
(administration & dosage)
- Stimulation, Chemical
- Terlipressin
- Vasoconstrictor Agents
(administration & dosage)
|