Coexistence of cushing syndrome from functional adrenal adenoma and addison disease from immune-mediated adrenalitis

Randall Colucci, Rafael E. Jimenez, William Farrar, Ramiro Malgor, Leonard Kohn, Frank L. Schwartz

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

A 56-year-old woman presented with an incidental adrenal adenoma and physical examination findings that included moderate obesity, a slight cervicothoracic fat pad ("buffalo hump"), increased supraclavicular fat pads, and white abdominal striae. Biochemical workup revealed elevated levels of 24-hour urinary free cortisol but normal serum morning cortisol and suppressed levels of corticotropin, suggestive of adrenal-dependent Cushing syndrome. The resected adrenal gland revealed macronodular cortical hyperplasia with a dominant nodule. Other findings included an absent cortisol response to corticotropin stimulation, presence of serum anti-21-hydroxylase antibodies, and mononuclear cell infiltration-consistent with adrenalitis. The findings represent, to the authors' knowledge, the first known case of a patient with coexistent functional cortisolsecreting macronodular adrenal tumor resulting in Cushing syndrome and immune-mediated adrenalitis resulting in Addison disease.

Original languageEnglish (US)
Pages (from-to)374-379
Number of pages6
JournalJournal of the American Osteopathic Association
Volume112
Issue number6
StatePublished - Jun 1 2012

ASJC Scopus subject areas

  • Complementary and alternative medicine

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