Clinical investigation of adrenal incidentalomas in Japanese patients of the fukuoka Rregion with updated diagnostic criteria for sub-clinical Cushing’s syndrome
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- Abe Ichiro
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Sugimoto Kaoru
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Miyajima Tetsumasa
- Department of Urology, Fukuoka University Chikushi Hospital, Japan
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- Ide Tomoko
- Department of Urology, Fukuoka University Chikushi Hospital, Japan
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- Minezaki Midori
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Takeshita Kaori
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Takahara Saori
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Nakagawa Midori
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Fujimura Yuki
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Kudo Tadachika
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
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- Miyajima Shigero
- Department of Urology, Fukuoka University Chikushi Hospital, Japan
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- Taira Hiroshi
- Department of Urology, Fukuoka University Chikushi Hospital, Japan
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- Ohe Kenji
- Department of Pharmacotherapeutics, Faculty of Pharmaceutical Sciences, Fukuoka University, Japan
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- Ishii Tatsu
- Department of Urology, Fukuoka University Chikushi Hospital, Japan
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- Yanase Toshihiko
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Japan
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- Kobayashi Kunihisa
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Japan
書誌事項
- タイトル別名
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- Clinical Investigation of Adrenal Incidentalomas in Japanese Patients of the Fukuoka Region with Updated Diagnostic Criteria for Sub-clinical Cushing's Syndrome
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説明
<p>Objectives We retrospectively investigated the clinical and endocrinological characteristics of adrenal incidentalomas. </p><p>Methods We studied 61 patients who had been diagnosed with adrenal incidentalomas and had undergone detailed clinical and endocrinological evaluations while hospitalized. We used common criteria to diagnose the functional tumors, but for sub-clinical Cushing's syndrome, we used an updated set of diagnosis criteria: serum cortisol ≥1.8 μg/dL after a positive response to a 1-mg dexamethasone suppression test if the patient has a low morning adrenocorticotropic hormone (ACTH) level (<10 pg/mL) and a loss of the diurnal serum cortisol rhythm. </p><p>Results Of the 61 patients, none (0%) had malignant tumors, 8 (13.1%) had pheochromocytoma, and 15 (24.6%) had primary aldosteronism; when diagnosed by our revised criteria, 13 (21.3%) had cortisol-secreting adenomas (Cushing's syndrome and sub-clinical Cushing's syndrome), and 25 (41.0%) had non-functional tumors. Compared with the non-functional tumor group, the primary aldosteronism group and the cortisol-secreting adenoma group were significantly younger and had significantly higher rates of hypokalemia, whereas the pheochromocytoma group had significantly larger tumors and a significantly lower body mass index. </p><p>Conclusion Our study found a larger percentage of functional tumors among adrenal incidentalomas than past reports, partly because we used a lower serum cortisol level after a dexamethasone suppression test to diagnose sub-clinical Cushing's syndrome and because all of the patients were hospitalized and could therefore receive more detailed examinations. Young patients with hypokalemia or lean patients with large adrenal tumors warrant particularly careful investigation. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 57 (17), 2467-2472, 2018-09-01
一般社団法人 日本内科学会