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

来源：

INTERNAL MEDICINE | 2012年 / 51卷 / 13期

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

页码：1709 / 1713

页数：5

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