MINERALOCORTICOID PRODUCTION OF ADRENAL-CORTICAL ADENOMAS

被引:11
作者
GLAZ, E
RACZ, K
VARGA, I
KISS, R
TOTH, M
FUTO, L
机构
[1] Second Department of Medicine, Semmelweis University Medical School, 1088 Budapest
关键词
D O I
10.1016/0960-0760(93)90122-D
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
We studied in vitro and in vivo corticosteroid production as well as the presence of symptoms of an increased mineralocorticoid effect in patients with 'silent' adrenal cortical adenomas, and compared these results to those found in patients with classical mineralocorticoid excess syndromes. We found that under in vitro conditions, cells from 'silent' adrenal cortical adenomas (n = 19) produced substantial amounts of both zona glomerulosa and fasciculata steroids, although the production of steroids in these cells was lower compared to that in mineralocorticoid-producing adenoma cells (n = 26). Patients with aldosterone-producing and 'silent' adenomas had significantly increased plasma atrial natriuretic peptide levels, which remained non-suppressible after upright posture and furosemide administration. Of the 25 patients with 'silent' adenomas, 11 had low and non-stimulable plasma renin activity (PRA) before but, in most cases, not after adrenal surgery. When compared to those with normal PRA (n = 14), patients with low PRA 'silent' adenomas (n = 11) had higher blood pressure which was significantly reduced after surgery, and a mild hypokalemia before but not after surgery. Although basal plasma concentrations of aldosterone, 18-hydroxy-corticosterone, corticosterone, deoxycorticosterone, 18-hydroxy-DOC, cortisol, 11-deoxycortisol and 17-hydroxy-progesterone (17-OH-P) were not increased in either groups of 'silent' adenomas, ACTH stimulation produced a hyperreactive response for all measured steroids, of which an extremely high 17-OH-P seemed to be one of the most intriguing findings. We consider that these observations in 'silent' adrenal cortical adenomas may justify surgical intervention, irrespective of the size and potential malignancy of these adenomas.
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页码:57 / 64
页数:8
相关论文
共 40 条
[31]   COEXPRESSION OF RENIN, ANGIOTENSINOGEN, AND THEIR MESSENGER RIBONUCLEIC-ACIDS IN ADRENAL TISSUES [J].
RACZ, K ;
PINET, F ;
GASC, JM ;
GUYENE, TT ;
CORVOL, P .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1992, 75 (03) :730-737
[32]   SUBTLE GLUCOCORTICOID EXCESS IN PATIENTS WITH ADRENAL INCIDENTALOMA [J].
ROSEN, HN ;
SWARTZ, SL .
AMERICAN JOURNAL OF MEDICINE, 1992, 92 (02) :213-216
[33]  
ROSS NS, 1990, NEW ENGL J MED, V323, P1401
[34]  
Sasano N, 1980, Pathol Annu, V15, P105
[35]  
SASANO N, 1991, FUNCTIONAL ENDOCRINE, V2, P546
[36]  
SERGEV O, 1990, KIDNEY INT, V38, pS107
[37]  
SERGEV O, 1991, CLIN EXP HYPERTENS A, V13, P409
[38]   EFFECT OF SODIUM RESTRICTION ON URINARY-EXCRETION OF 19-NORALDOSTERONE AND 18,19-DIHYDROXYCORTICOSTERONE, NEWLY IDENTIFIED MINERALOCORTICOIDS IN MAN [J].
TAKEDA, Y ;
MIYAMORI, I ;
TAKEDA, R ;
LEWICKA, S ;
VECSEI, P .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1992, 74 (05) :1195-1197
[39]   ENDOCRINE ABNORMALITIES IN PATIENTS WITH ADRENAL-TUMORS INCIDENTALLY DISCOVERED ON COMPUTED-TOMOGRAPHY [J].
VIRKKALA, A ;
VALIMAKI, M ;
PELKONEN, R ;
HUIKURI, K ;
KAHRI, A ;
KIVISAARI, L ;
KORHONEN, T ;
SALMI, J ;
SEPPALA, P .
ACTA ENDOCRINOLOGICA, 1989, 121 (01) :67-72
[40]   PLASMA-LEVELS OF ATRIAL-NATRIURETIC-PEPTIDE IN PRIMARY ALDOSTERONISM AND ESSENTIAL-HYPERTENSION [J].
YAMAJI, T ;
ISHIBASHI, M ;
SEKIHARA, H ;
TAKAKU, F ;
NAKAOKA, H ;
FUJII, J .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1986, 63 (04) :815-818