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Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
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A Novel Method: Super-selective Adrenal Venous Sampling
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Published on: September 15, 2017

Concurrent primary aldosteronism and subclinical cortisol hypersecretion: a prospective study.

Francesco Fallo1, Chiara Bertello, Davide Tizzani

  • 1Department of Medical and Surgical Sciences, University of Padova, Padova, Italy. francesco.fallo@unipd.it

Journal of Hypertension
|July 2, 2011
PubMed
Summary

Subclinical hypercortisolism is rare in primary aldosteronism, but detecting it is crucial. This study found concurrent aldosterone and cortisol overproduction in one patient, highlighting the importance of appropriate testing to avoid misinterpreting adrenal venous sampling results.

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Published on: September 15, 2017

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
08:02

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Published on: April 25, 2016

Area of Science:

  • Endocrinology
  • Hypertension Research
  • Cardiovascular Medicine

Background:

  • Primary aldosteronism is a common cause of secondary hypertension.
  • It increases the risk of cardiometabolic complications.
  • Subtle cortisol overproduction may exacerbate this cardiovascular risk.

Purpose of the Study:

  • To prospectively evaluate the incidence of subclinical hypercortisolism in patients with primary aldosteronism.
  • To investigate the potential link between cortisol and aldosterone hypersecretion.

Main Methods:

  • 76 hypertensive patients with primary aldosteronism underwent screening for subclinical hypercortisolism.
  • Subclinical hypercortisolism was defined by specific hormonal criteria after dexamethasone suppression testing.
  • Imaging and adrenal venous sampling (AVS) were used for differential diagnosis.

Main Results:

  • Only one of 76 patients met the criteria for subclinical hypercortisolism.
  • This patient had a cortisol-producing adenoma and aldosterone-producing hyperplasia.
  • Adrenalectomy normalized hormone levels, confirmed at 12-month follow-up.

Conclusions:

  • Concurrent aldosterone and subclinical cortisol hypersecretion is uncommon in primary aldosteronism.
  • Accurate diagnostic testing is essential to prevent misinterpretation of AVS.
  • Identifying coexisting conditions is vital for managing cardiovascular risk.