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  1. 医学部
  1. 医学部
  2. 学術雑誌掲載論文  (医学部)

False-positive results of adrenal venous sampling due to mild autonomous cortisol secretion in a patient with primary aldosteronism: a case report with review of literature

http://hdl.handle.net/10458/0002001777
http://hdl.handle.net/10458/0002001777
6ba22298-f57d-4a65-9d0f-02de7df51468
名前 / ファイル ライセンス アクション
advpub_EJ25-0312.pdf fulltext (4.5 MB)
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アイテムタイプ 学術雑誌論文 / Journal Article(1)
公開日 2025-10-02
タイトル
タイトル False-positive results of adrenal venous sampling due to mild autonomous cortisol secretion in a patient with primary aldosteronism: a case report with review of literature
言語 en
言語
言語 eng
キーワード
言語 en
キーワード Adrenal venous sampling
キーワード
言語 en
キーワード Immunohistochemistry
キーワード
言語 en
キーワード Mild autonomous cortisol secretion
キーワード
言語 en
キーワード Primary aldosteronism
資源タイプ
資源タイプ journal article
アクセス権
アクセス権 open access
著者 Wada, Norio

× Wada, Norio

en Wada, Norio(Personal)
Sapporo City General Hospital

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Baba, Shuhei

× Baba, Shuhei

en Baba, Shuhei(Personal)
Sapporo City General Hospital

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Sugawara, Hajime

× Sugawara, Hajime

en Sugawara, Hajime(Personal)
Sapporo City General Hospital

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Miyoshi, Arina

× Miyoshi, Arina

en Miyoshi, Arina(Personal)
Sapporo City General Hospital

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Obara, Shinji

× Obara, Shinji

en Obara, Shinji(Personal)
Sapporo City General Hospital

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Sanada, Miwa

× Sanada, Miwa

en Sanada, Miwa(Personal)
Sapporo City General Hospital

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Tsuji, Takahiro

× Tsuji, Takahiro

en Tsuji, Takahiro(Personal)
Sapporo City General Hospital

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西本, 紘嗣郎

× 西本, 紘嗣郎

WEKO 35349
e-Rad_Researcher 00365363

ja 西本, 紘嗣郎
宮崎大学

ja-Kana ニシモト, コウシロウ

en Nishimoto, Koshiro
University of Miyazaki

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Mukai, Kuniaki

× Mukai, Kuniaki

en Mukai, Kuniaki(Personal)
Keio University

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抄録
内容記述タイプ Abstract
内容記述 We report the case of a 50-year-old female diagnosed with primary aldosteronism (PA) complicated with mild autonomous cortisol secretion (MACS). The patient had a 5-year history of hypertension, and screening revealed an elevated aldosterone-to-renin ratio (ARR). Although she demonstrated no clinical features of Cushing's syndrome, her serum potassium level was at the lower end of the normal range. The baseline plasma renin activity was <0.2 ng/mL/h, and the plasma aldosterone concentration was 165 pg/mL. Confirmatory tests supported the diagnosis of PA, and computed tomography (CT) revealed a 19-mm tumor in the left adrenal gland. Following a 1-mg dexamethasone suppression test, her serum cortisol level measured 9.0 μg/dL, and the diurnal rhythm of cortisol secretion was absent. Plasma adrenocorticotropic hormone (ACTH) was suppressed. Adrenal venous sampling (AVS) revealed right-sided dominance before and after ACTH stimulation, with lateralization indices of 43.8 and 5.0, respectively. Considering the findings, we prioritized treatment for MACS and performed left adrenalectomy. Hypertension and elevated ARR persisted postoperatively. Histopathological examination revealed a 26-mm CYP11B-positive and CYP11B2-negative adenoma. The surrounding adrenal cortex contained multiple CYP11B1-negative and CYP11B2-positive nodules and micronodules. This case was retrospectively considered to represent bilateral PA. The AVS interpretation was misleading owing to cortisol imbalance between the adrenal veins due to cortisol producing adenoma. Treatment strategies for patients with PA and concurrent MACS should encompass a comprehensive assessment of AVS and CT findings.
言語 en
書誌情報 en : Endocrine journal

p. EJ25-0312, 発行日 2025-09-19
出版者
出版者 Japan Endocrine Society
言語 en
ISSN
収録物識別子タイプ EISSN
収録物識別子 13484540
DOI
関連タイプ isVersionOf
識別子タイプ DOI
関連識別子 https://doi.org/10.1507/endocrj.EJ25-0312
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出版タイプ VoR
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