Usefulness and Limitations of Unilateral Adrenalectomy for ACTH-independent Macronodular Adrenal Hyperplasia in a Patient with Poor Glycemic Control
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作者:
Kobayashi, Takaaki
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Kobayashi, Takaaki
[1
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Miwa, Takashi
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Miwa, Takashi
[1
]
Kan, Kenshi
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Kan, Kenshi
[1
]
Takeda, Misato
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Takeda, Misato
[1
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Sakai, Hiroyuki
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Sakai, Hiroyuki
[1
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Kanazawa, Akira
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Kanazawa, Akira
[1
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Tanaka, Akihiko
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Toda Chuo Gen Hosp, Toda, Saitama, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Tanaka, Akihiko
[2
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Namiki, Kazunori
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Tokyo Med Univ, Dept Urol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Namiki, Kazunori
[3
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Nagao, Toshitaka
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Tokyo Med Univ, Dept Pathol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Nagao, Toshitaka
[4
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Odawara, Masato
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Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, JapanTokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
Odawara, Masato
[1
]
机构:
[1] Tokyo Med Univ, Dept Internal Med 3, Div Diabet Metab & Endocrinol, Tokyo, Japan
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.