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Primary aldosteronism combined with preclinical Cushing's syndrome in an elderly patient.

Abstract
Pre-clinical Cushing's syndrome (pre-CS) is sometimes seen with adrenal cortical tumors. An 80-year-old woman had severe hypertension and hypokalemia, the typical clinical features of primary aldosteronism, but detailed hormonal examinations revealed the accompanying pre-CS. After adrenalectomy by laparoscopy, her blood pressure was remarkably reduced and the hypokalemia also recovered. The tumor consisted of mostly light clear cells and scattered dark compact cells resembling islands. Abundant expression of cytochrome P450 aldosterone synthase in the clear cells and cytochrome P450 11beta-hydroxylase in the dark cells was detected by immunohistochemical studies, which confirmed that clear cells can produce aldosterone and compact cells can produce cortisol.
AuthorsHideki Fujii, Kei Kamide, Osamu Miyake, Toyofumi Abe, Michiko Nagai, Hajime Nakahama, Takeshi Horio, Shin Takiuchi, Akihiko Okuyama, Chikao Yutani, Yuhei Kawano
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 69 Issue 11 Pg. 1425-7 (Nov 2005) ISSN: 1346-9843 [Print] Japan
PMID16247222 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Aldosterone
  • Cytochrome P-450 CYP11B2
  • Hydrocortisone
Topics
  • Adrenal Cortex Neoplasms (complications, metabolism, therapy)
  • Adrenal Glands (metabolism)
  • Adrenalectomy (methods)
  • Aged, 80 and over
  • Aldosterone (metabolism)
  • Cushing Syndrome (complications, metabolism, therapy)
  • Cytochrome P-450 CYP11B2 (metabolism)
  • Female
  • Humans
  • Hydrocortisone (metabolism)
  • Hyperaldosteronism (complications, metabolism, therapy)
  • Hypokalemia (complications, metabolism, therapy)

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