Usefulness and Limitations of Unilateral Adrenalectomy for ACTH-independent Macronodular Adrenal Hyperplasia in a Patient with Poor Glycemic Control

被引:13
作者
Kobayashi, Takaaki [1 ]
Miwa, Takashi [1 ]
Kan, Kenshi [1 ]
Takeda, Misato [1 ]
Sakai, Hiroyuki [1 ]
Kanazawa, Akira [1 ]
Tanaka, Akihiko [2 ]
Namiki, Kazunori [3 ]
Nagao, Toshitaka [4 ]
Odawara, Masato [1 ]
机构
[1] Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
[2] Toda Chuo Gen Hosp, Toda, Saitama, Japan
[3] Tokyo Med Univ, Dept Urol, Tokyo, Japan
[4] Tokyo Med Univ, Dept Pathol, Tokyo, Japan
关键词
ACTH-independent macronodular adrenal hyperplasia; Cushing's syndrome; CUSHINGS-SYNDROME; ADRENOCORTICAL HYPERPLASIA; THERAPY; EFFICACY; GLANDS; AIMAH;
D O I
10.2169/internalmedicine.51.7041
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Adrenocorticotropic hormone (ACTH)-independent macronodular adrenal hyperplasia (AIMAH) is a rare disease which causes Cushing's syndrome. Bilateral adrenalectomy has been recommended as the treatment of choice for AIMAH. However, bilaterally adrenalectomized patients require lifelong steroid replacement therapy. Therefore, an increasing number of patients have undergone unilateral adrenalectomy for AIMAH. We report a case of AIMAH due to refractory diabetes in whom unilateral adrenalectomy initially yielded good diabetes control, but in whom poor glycemic control developed after 5 years, requiring eventual additional contralateral adrenalectomy. In elderly patients with AIMAH, one-stage bilateral adrenalectomy may be the treatment of choice.
引用
收藏
页码:1709 / 1713
页数:5
相关论文
共 13 条
[1]  
Aiba Motohiko, 1994, Folia Endocrinologica Japonica, V70, P37
[2]   Unilateral adrenalectomy can be an alternative therapy for infantile onset Cushing's syndrome caused by ACTH-independent macronodular adrenal hyperplasia with McCune-Albright syndrome [J].
Hamajima, Takashi ;
Maruwaka, Kaori ;
Homma, Keiko ;
Matsuo, Kumihiro ;
Fujieda, Kenji ;
Hasegawa, Tomonobu .
ENDOCRINE JOURNAL, 2010, 57 (09) :819-824
[3]   The role of unilateral adrenalectomy in ACTH-independent macronodular adrenal hyperplasia (AIMAH) [J].
Iacobone, Maurizio ;
Albiger, Nora ;
Scaroni, Carla ;
Mantero, Franco ;
Fassina, Ambrogio ;
Viel, Giovanni ;
Frego, Mauro ;
Favia, Gennaro .
WORLD JOURNAL OF SURGERY, 2008, 32 (05) :882-889
[4]   Steroid Biosynthesis Inhibitors in the Therapy of Hypercortisolism: Theory and Practice [J].
Igaz, P. ;
Tombol, Z. ;
Szabo, P. M. ;
Liko, I. ;
Racz, K. .
CURRENT MEDICINAL CHEMISTRY, 2008, 15 (26) :2734-2747
[5]   A case of ACTH-independent bilateral macronodular adrenal hyperplasia successfully treated by subtotal resection of the adrenal glands: Four-year follow-up [J].
Kageyama, Y ;
Ishizaka, K ;
Iwashina, M ;
Sasano, H ;
Kihara, K .
ENDOCRINE JOURNAL, 2002, 49 (02) :227-229
[6]   CUSHINGS SYNDROME - NODULAR CORTICAL HYPERPLASIA OF ADRENAL GLANDS WITH CLINICAL + PATHOLOGICAL FEATURES SUGGESTING ADRENOCORTICAL TUMOR [J].
KIRSCHNER, MA ;
POWELL, RD ;
LIPSETT, MB .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1964, 24 (10) :947-+
[7]   Adrenal Cushing's Syndrome Due to Bilateral Macronodular Adrenal Hyperplasia: Prediction of the Efficacy of β-blockade Therapy and Interest of Unilateral Adrenalectomy [J].
Mazzuco, Tania L. ;
Chaffanjon, Philippe ;
Martinie, Monique ;
Sturm, Nathalie ;
Chabre, Olivier .
ENDOCRINE JOURNAL, 2009, 56 (07) :867-877
[8]   Adrenocorticotropic hormone-independent bilateral adrenocortical macronodular hyperplasia treated with mitotane [J].
Nagai, M ;
Narita, I ;
Omori, K ;
Komura, S ;
Arakawa, M .
INTERNAL MEDICINE, 1999, 38 (12) :969-973
[9]   Long-term Efficacy of Trilostane for Cushing's Syndrome due to Adrenocorticotropin-Independent Bilateral Macronodular Adrenocortical Hyperplasia [J].
Obata, Yoshinari ;
Yamada, Yuya ;
Baden, Megu Yamaguchi ;
Hosokawa, Yoshiya ;
Saisho, Kenji ;
Tamba, Sachiko ;
Yamamoto, Koji ;
Matsuzawa, Yuji .
INTERNAL MEDICINE, 2011, 50 (21) :2621-2625
[10]   Diabetes, hypertension, and manic episodes [J].
Odawara, M ;
Tada, K ;
Akaza, H ;
Yamashita, K .
LANCET, 1996, 348 (9026) :518-518