Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature
Abstract Background The prevalence of primary aldosteronism concurrent with subclinical Cushing’s syndrome was higher than previously thought. Through analyzing a rare clinical case, we summarized the diagnosis and management of primary aldosteronism with subclinical Cushing’s syndrome. Case present...
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doaj-4367f237563045f880d3194fc5c2d0572020-11-25T02:04:15ZengBMCJournal of Medical Case Reports1752-19472020-02-011411710.1186/s13256-020-2353-8Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literatureYingxiao Zhang0Jianyu Tan1Qin Yang2Zhipeng Du3Shumin Yang4Wenwen He5Ying Song6Jinbo Hu7Yi Yang8Qifu Li9Yao Zhang10Yunfeng He11Qingfeng Cheng12the Chongqing Primary Aldosteronism Study (CONPASS) GroupDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Endocrinology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background The prevalence of primary aldosteronism concurrent with subclinical Cushing’s syndrome was higher than previously thought. Through analyzing a rare clinical case, we summarized the diagnosis and management of primary aldosteronism with subclinical Cushing’s syndrome. Case presentation A 54-year-old Chinese man of Han nationality was diagnosed as having primary aldosteronism with subclinical Cushing’s syndrome. An abdominal computed tomography scan revealed a mass in his left adrenal gland and a mass in his right adrenal gland. After finishing sequential adrenal venous sampling without adrenocorticotropic hormone, the result reminded us that the left and right nodules were responsible for hypercortisolism and aldosterone hypersecretion, respectively. Right and left adrenalectomy were performed successively. The pathological diagnosis was adrenocortical adenoma for both. Histological findings revealed that the right one had positive immunostaining for CYP11B2 and the left one had positive immunostaining for CYP11B1. The immunohistochemistry result helped us to confirm the diagnosis. Somatic KCNJ5 mutation (Leu168Arg) was found in the right tumor; there was no KCNJ5 mutation in the left adrenal tumor. Conclusions We suggest that patients with primary aldosteronism should have a low-dose overnight dexamethasone suppression test to screen for hypercortisolism. It can help avoid misdiagnoses and contribute to proper understanding of the adrenal vein sampling result. Making sure of the nidus of aldosterone and cortisol secretion is crucial for the therapy of patients with primary aldosteronism and subclinical Cushing’s syndrome.http://link.springer.com/article/10.1186/s13256-020-2353-8Primary aldosteronismSubclinical Cushing’s syndromeAdrenal vein samplingSubtype |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yingxiao Zhang Jianyu Tan Qin Yang Zhipeng Du Shumin Yang Wenwen He Ying Song Jinbo Hu Yi Yang Qifu Li Yao Zhang Yunfeng He Qingfeng Cheng the Chongqing Primary Aldosteronism Study (CONPASS) Group |
spellingShingle |
Yingxiao Zhang Jianyu Tan Qin Yang Zhipeng Du Shumin Yang Wenwen He Ying Song Jinbo Hu Yi Yang Qifu Li Yao Zhang Yunfeng He Qingfeng Cheng the Chongqing Primary Aldosteronism Study (CONPASS) Group Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature Journal of Medical Case Reports Primary aldosteronism Subclinical Cushing’s syndrome Adrenal vein sampling Subtype |
author_facet |
Yingxiao Zhang Jianyu Tan Qin Yang Zhipeng Du Shumin Yang Wenwen He Ying Song Jinbo Hu Yi Yang Qifu Li Yao Zhang Yunfeng He Qingfeng Cheng the Chongqing Primary Aldosteronism Study (CONPASS) Group |
author_sort |
Yingxiao Zhang |
title |
Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature |
title_short |
Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature |
title_full |
Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature |
title_fullStr |
Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature |
title_full_unstemmed |
Primary aldosteronism concurrent with subclinical Cushing’s syndrome: a case report and review of the literature |
title_sort |
primary aldosteronism concurrent with subclinical cushing’s syndrome: a case report and review of the literature |
publisher |
BMC |
series |
Journal of Medical Case Reports |
issn |
1752-1947 |
publishDate |
2020-02-01 |
description |
Abstract Background The prevalence of primary aldosteronism concurrent with subclinical Cushing’s syndrome was higher than previously thought. Through analyzing a rare clinical case, we summarized the diagnosis and management of primary aldosteronism with subclinical Cushing’s syndrome. Case presentation A 54-year-old Chinese man of Han nationality was diagnosed as having primary aldosteronism with subclinical Cushing’s syndrome. An abdominal computed tomography scan revealed a mass in his left adrenal gland and a mass in his right adrenal gland. After finishing sequential adrenal venous sampling without adrenocorticotropic hormone, the result reminded us that the left and right nodules were responsible for hypercortisolism and aldosterone hypersecretion, respectively. Right and left adrenalectomy were performed successively. The pathological diagnosis was adrenocortical adenoma for both. Histological findings revealed that the right one had positive immunostaining for CYP11B2 and the left one had positive immunostaining for CYP11B1. The immunohistochemistry result helped us to confirm the diagnosis. Somatic KCNJ5 mutation (Leu168Arg) was found in the right tumor; there was no KCNJ5 mutation in the left adrenal tumor. Conclusions We suggest that patients with primary aldosteronism should have a low-dose overnight dexamethasone suppression test to screen for hypercortisolism. It can help avoid misdiagnoses and contribute to proper understanding of the adrenal vein sampling result. Making sure of the nidus of aldosterone and cortisol secretion is crucial for the therapy of patients with primary aldosteronism and subclinical Cushing’s syndrome. |
topic |
Primary aldosteronism Subclinical Cushing’s syndrome Adrenal vein sampling Subtype |
url |
http://link.springer.com/article/10.1186/s13256-020-2353-8 |
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