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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.

Carlos Esteban Builes-Montaño, Hospital Pablo Tobón Uribe

Sección de Endocrinología, Departamento de Medicina Interna. Hospital Pablo Tobón Uribe

Carlos Andres Villa-Franco, Hospital Pablo Tobón Uribe

Departamento de Medicina Interna. Hospital Pablo Tobón Uribe

Alejandro Román-Gonzalez, Universidad de Antioquia

Sección de Endocrinología, Departamento de Medicina Interna. Universidad de Antioquia

Alejandro Vélez-Hoyos, Hospital Pablo Tobón Uribe

Departamento de Patología. Hospital Pablo Tobón Uribe

Santiago Echeverri-Isaza, Hospital Pablo Tobón Uribe

Departamento de Radiología. Hospital Pablo Tobón Uribe

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Received 2015-04-20
Accepted 2015-06-09
Published 2015-06-30