ECE2014 Poster Presentations Clinical case reports Pituitary/Adrenal (50 abstracts)
A case of primary aldosteronism with the subclinical Cushing's syndrome examined the localization by double immunostaining for CYP11B1 and B2
Takeshi Hayashi 1, , Hiroshi Asano 1 , Masaya Sakamoto 1 , Noriko Sakamoto 1 , Isao Kurihara 2 , Kuniaki Mukai 3 , Katsuyoshi Tojo 1 & Kazunori Utsunomiya 1
1Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine, Tokyo, Japan; 2Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan; 3Departments of Biochemistry and Integrative Medical Biology, School of Medicine, Keio University, Tokyo, Japan.
A 63-year-old woman was referred to our hospital for examination of three adrenal nodules. She had been diagnosed with hypertension since the age of 40 and prescribed antihypertensive drugs. Then, she was pointed out hypokalemia and bilateral adrenal tumors. She was diagnosed with primary aldosteronism (PA) at another hospital and had been prescribed spironolactone because the localization was not determined despite adrenal vein sampling (AVS) was performed.
Her parents had been suffering from hypertension and her daughter had been excised adrenal gland in Cushing’s syndrome. She didn’t have the cushingoid appearances, but her blood pressure was still high and hypokalemia had been continued. Abdominal MRI revealed three adrenal nodules (right 1 and 3 cm, left 1 cm). Three kinds of loading tests for the diagnosis of PA were all positive. Diurnal variation of plasma ACTH and cortisol was lost. 1 mg dexamethasone didn’t suppress her cortisol. From these results, she was diagnosed with the coexistence of PA and subclinical Cushing’s syndrome (SCS), AVS was performed to confirm the localization of each. Plasma aldosterone concentration was elevated at the right adrenal vein (11 800/149 000) (pre/post ACTH) (pg/ml). Cortisol of the right adrenal vein was not enough, but it would be suppressed by SCS at left adrenal gland (Left 86.5/805, Right 7.7/72.5) (pre/post ACTH) (μg/dl). However, larger nodule in the right adrenal gland also had the possibility of SCS, because SCS often caused by macro nodule. Hence, we examined the localization of SCS and PA by double immunostaining for CYP11B1 and B2 after the operation of the PA of the right adrenal gland. Surprisingly, CYB11B2 was stained at the portion of the larger nodule of right and CYP11B1 was stained the rest of it and small nodules of the right. This is the rare case of examined the localization by double immunostaining.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more