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Endocrine

, Volume 41, Issue 1, pp 160–161 | Cite as

Assessment of long-term efficacy and safety of metyrapone monotherapy in a patient with ACTH-independent macronodular adrenal hyperplasia

  • Masanori YoshidaEmail author
  • Hiroshi Umeda
  • Shintaro Iwama
  • Seiko Nakayama
  • Misaki Miyata
  • Koichiro Ogawa
  • Harumi Maeda
  • Yutaka Oiso
Letter to the Editor

To the Editor,

ACTH-independent macronodular adrenocortical hyperplasia (AIMAH) is a rare form of Cushing’s syndrome (CS), characterized by macronodular enlargement of the bilateral adrenal glands. Although an 11β-hydroxylase inhibitor, metyrapone, has been used in inoperable CS cases, its efficacy and safety for AIMAH are still unclear. The curative therapy for AIMAH is bilateral adrenalectomy; however, because AIMAH usually occurs in elderly persons, patients often have high operation risks.

A 69-year-old woman, with apparent cushingoid features, was referred to us for hypokalemia (2.1 mEq/l) after coronary artery bypass graft surgery for triple-vessel disease. She received insulin therapy for diabetes (HbA1c, 8.8%). Abdominal computed tomography revealed macronodular enlargement of the adrenal glands (right, 48 × 31 mm; left, 55 × 33 mm). Morning plasma ACTH and cortisol levels were <5.0 pg/ml (reference 7.4–54.7) and 19.0 μg/dl (reference 4.0–18.3), respectively. The cortisol level...

Keywords

Cortisol Level Pioglitazone Metyrapone Adrenal Lesion Urinary Free Cortisol Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Masanori Yoshida
    • 1
    Email author
  • Hiroshi Umeda
    • 1
  • Shintaro Iwama
    • 1
    • 2
  • Seiko Nakayama
    • 1
  • Misaki Miyata
    • 1
  • Koichiro Ogawa
    • 1
  • Harumi Maeda
    • 1
  • Yutaka Oiso
    • 2
  1. 1.Department of Endocrinology and DiabetesNagoya Ekisaikai HospitalNagoyaJapan
  2. 2.Department of Endocrinology and DiabetesNagoya University School of MedicineNagoyaJapan

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