Adrenal venous sampling in a patient with adrenal Cushing syndrome
Abstract
The primary bilateral macronodular adrenal hyperplasia or the independent adrenocorticotropic hormone bilateral nodular adrenal hyperplasia is a rare cause hypercortisolism, its diagnosis is challenging and there is no clear way to decide the best therapeutic approach. Adrenal venous sampling is commonly used to distinguish the source of hormonal production in patients with primary hyperaldosteronism. It could be a useful tool in this context because it might provide information to guide the treatment. We report the case of a patient with ACTH independent Cushing syndrome in whom the use of adrenal venous sampling with some modifications radically modified the treatment and allowed the diagnosis of a macronodular adrenal hyperplasia.Authors
Downloads
Keywords
- Cushing syndrome
- adrenal cortex diseases
- adrenal cortex function tests
References
Montoya-Escobar J, Builes-Montaño C, Johnayro G-R, Campuzano MG. Muestreo de senos petrosos inferiores en el diagnóstico de pacientes con síndrome de Cushing dependiente de hormona adrenocorticotrópica. Med Lab. 2013; 19(9-10): 411-50.
Dinneen SF, Carney JA, Carpenter PC, Grant CS, Young WF. Acth-independent Cushing’s syndrome: bilateral cortisol-producing adrenal adenomas. Endocr Pract. 1995; 1(2): 77-81.
Young WF Jr, du Plessis H, Thompson GB, Grant CS, Farley DR, Richards ML, et al. The clinical conundrum of corticotropin-independent autonomous cortisol secretion in patients with bilateral adrenal masses. World J Surg. 2008; 32(5): 856-62.
De Venanzi A, Alencar GA, Bourdeau I, Fragoso MC, Lacroix A. Primary bilateral macronodular adrenal hyperplasia. Curr Opin Endocrinol Diabetes Obes. 2014; 21(3): 177-84.
Young WF, Stanson AW, Thompson GB, Grant CS, Farley DR, van Heerden JA. Role for adrenal venous sampling in primary aldosteronism. Surgery. 2004; 136(6): 1227-35.
Stewart PM, Allolio B. Adrenal vein sampling for Primary Aldosteronism: time for a reality check. Clin Endocrinol (Oxf). 2010; 72(2): 146-8.
Maghrabi A, Yaqub A, Denning KL, Benhamed N, Faiz S, Saleem T. Challenges in the diagnostic work-up and management of patients with subclinical Cushing’s syndrome and bilateral adrenal masses. Endocrine Practice. 2013; 19(3): 515-21.
Lieberman SA, Eccleshall TR, Feldman D. ACTH-independent massive bilateral adrenal disease (AIMBAD): a subtype of Cushing’s syndrome with major diagnostic and therapeutic implications. European J Endocrinol. 1994; 131(1): 67-73
Akehi Y, Kawate H, Murase K, Nagaishi R, Nomiyama T, Nomura M, et al. Proposed diagnostic criteria for subclinical Cushing’s syndrome associated with adrenal incidentaloma. Endocrine J. 2013;60(7):903-12.
Kidambi S, Raff H, Findling JW. Limitations of nocturnal salivary cortisol and urine free cortisol in the diagnosis of mild Cushing’s syndrome. European J Endocrinol. 2007; 157(6): 725-31.
Lacroix A. ACTH-independent macronodular adrenal hyperplasia. Best Prac Res Clin Endocrinol Metab. 2009; 23(2): 245-59.
Copyright (c) 2015 Universidad del Valle
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use
