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. 2018 Mar 25:2018:4920841.
doi: 10.1155/2018/4920841. eCollection 2018.

Clinical Characteristics of Aldosterone- and Cortisol-Coproducing Adrenal Adenoma in Primary Aldosteronism

Lu Tang  1 , Xintao Li  2 , Baojun Wang  1 , Xin Ma  1 , Hongzhao Li  1 , Yu Gao  1 , Liangyou Gu  1 , Wenyuan Nie  1 , Xu Zhang  1
Affiliations

Clinical Characteristics of Aldosterone- and Cortisol-Coproducing Adrenal Adenoma in Primary Aldosteronism

Lu Tang et al. Int J Endocrinol. .

Abstract

Aldosterone- and cortisol-coproducing adrenal adenoma (A/CPA) cases have been observed in patients with primary aldosteronism (PA). This study investigated the incidence, clinical characteristics, and molecular biological features of patients with A/CPAs. We retrospectively identified 22 A/CPA patients from 555 PA patients who visited the Chinese People's Liberation Army General Hospital between 2004 and 2015. Analysis of clinical parameters revealed that patients with A/CPAs had larger tumors than those with pure APAs (P < 0.05). Moreover, they had higher proportions of cardiovascular complications, glucose intolerance/diabetes, and osteopenia/osteoporosis compared to the pure APA patients (P < 0.001). In the molecular biological findings, quantitative real-time PCR analysis revealed similar CYP11B1 and CYP17A1 mRNA expressions in resected A/CPA specimens and in pure APA specimens. Western blot and immunochemical analyses showed CYP11B1, CYP11B2, and CYP17A1 expressions in both A/CPAs and pure APAs. Seventeen cases with KCNJ5 mutations were detected among the 22 A/CPA DNA samples, but no PRKACA or other causative mutations were observed. Each patient improved following adrenalectomy. In conclusion, A/CPAs were not rare among PA patients. These patients associated with high incidences of cardiovascular events and metabolic disorders. Screening for excess cortisol secretion is necessary for PA patients.

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Figures

Figure 1
Figure 1
CYP11B1, CYP11B2, and CYP17A1 mRNA and protein expression levels in A/CPA tissue, pure APA tissue, and normal adrenal glands (NAGs). (a) Western blot showing CYP11B1, CYP11B2, and CYP17A1 protein bands in the A/CPA, pure APA, and NAG tissues. (b) The intensity of the CYP11B1, CYP11B2, and CYP17A1 protein bands compared with β-actin. (c) CYP11B1, CYP11B2, and CYP17A1 mRNA expressions in A/CPA, pure APA, and NAG tissues. ∗ P < 0.05, ∗∗ P < 0.01, ∗∗∗ P < 0.001.
Figure 2
Figure 2
Immunohistochemistry results for CYP11B1, CYP11B2, CYP17A1, and hematoxylin-eosin stain (HES) in A/CPA and pure APA tissue.
See this image and copyright information in PMC

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