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Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden

Olsen, Henrik LU ; Nordenström, Erik LU ; Bergenfelz, Anders LU ; Nyman, Ulf LU ; Valdemarsson, Stig LU and Palmqvist, Erik (2012) In Endocrine 42(1). p.164-173
Abstract
Evaluation of subclinical hypercortisolism (SH) in patients with adrenal incidentaloma (AI) including its correlation to size, attenuation at unenhanced computed tomography (CT) and unilateral or bilateral adrenal disease. Nine hospitals in Southern Sweden investigated during 2005-2007 consecutively patients with AI with hormonal and CT examinations according a regional protocol. Two hundred and twenty-eight patients with AI with median size 2.0 cm were included. One mg overnight dexamethasone suppression test (DST) was performed in 223 patients and basal P-ACTH measured in 146 patients. SH was defined as cortisol >= 50 nmol/l at DST in combination with basal ACTH <2 pmol/l. In patients with unilateral AI 42% (76/180) had inadequate... (More)
Evaluation of subclinical hypercortisolism (SH) in patients with adrenal incidentaloma (AI) including its correlation to size, attenuation at unenhanced computed tomography (CT) and unilateral or bilateral adrenal disease. Nine hospitals in Southern Sweden investigated during 2005-2007 consecutively patients with AI with hormonal and CT examinations according a regional protocol. Two hundred and twenty-eight patients with AI with median size 2.0 cm were included. One mg overnight dexamethasone suppression test (DST) was performed in 223 patients and basal P-ACTH measured in 146 patients. SH was defined as cortisol >= 50 nmol/l at DST in combination with basal ACTH <2 pmol/l. In patients with unilateral AI 42% (76/180) had inadequate suppression at DST and 23% (27/115) had SH. The probability for SH and inadequate suppression at DST correlated positively to size and inversely to attenuation at CT. Bilateral AI were found in 43 patients and of these 70% (30/43) had inadequate suppression at DST and 42% (13/31) SH. The patients with SH or inadequate suppression at DST had increased frequency of hypertension which increased further in patients with post-DST cortisol >= 140 nmol/l. The applied criterion for SH is useful for initial evaluation of patients with AI. SH is common in patients with AI, particular in bilateral disease. In patients with unilateral AI the probability for SH correlated positively to size and inversely to attenuation at CT. Furthermore, SH and the post-DST cortisol concentration was associated with hypertension. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adrenal incidentaloma, Subclinical Cushing syndrome, Subclinical, hypercortisolism, Adrenal CT, Adrenal imaging, Houndsfield units
in
Endocrine
volume
42
issue
1
pages
164 - 173
publisher
Humana Press
external identifiers
  • wos:000309155700023
  • scopus:84864967238
ISSN
1355-008X
DOI
10.1007/s12020-012-9622-2
language
English
LU publication?
yes
id
e3340e34-ebca-4407-ba95-7b9439a58bf0 (old id 3188101)
date added to LUP
2012-12-03 07:08:41
date last changed
2017-11-19 03:00:14
@article{e3340e34-ebca-4407-ba95-7b9439a58bf0,
  abstract     = {Evaluation of subclinical hypercortisolism (SH) in patients with adrenal incidentaloma (AI) including its correlation to size, attenuation at unenhanced computed tomography (CT) and unilateral or bilateral adrenal disease. Nine hospitals in Southern Sweden investigated during 2005-2007 consecutively patients with AI with hormonal and CT examinations according a regional protocol. Two hundred and twenty-eight patients with AI with median size 2.0 cm were included. One mg overnight dexamethasone suppression test (DST) was performed in 223 patients and basal P-ACTH measured in 146 patients. SH was defined as cortisol &gt;= 50 nmol/l at DST in combination with basal ACTH &lt;2 pmol/l. In patients with unilateral AI 42% (76/180) had inadequate suppression at DST and 23% (27/115) had SH. The probability for SH and inadequate suppression at DST correlated positively to size and inversely to attenuation at CT. Bilateral AI were found in 43 patients and of these 70% (30/43) had inadequate suppression at DST and 42% (13/31) SH. The patients with SH or inadequate suppression at DST had increased frequency of hypertension which increased further in patients with post-DST cortisol &gt;= 140 nmol/l. The applied criterion for SH is useful for initial evaluation of patients with AI. SH is common in patients with AI, particular in bilateral disease. In patients with unilateral AI the probability for SH correlated positively to size and inversely to attenuation at CT. Furthermore, SH and the post-DST cortisol concentration was associated with hypertension.},
  author       = {Olsen, Henrik and Nordenström, Erik and Bergenfelz, Anders and Nyman, Ulf and Valdemarsson, Stig and Palmqvist, Erik},
  issn         = {1355-008X},
  keyword      = {Adrenal incidentaloma,Subclinical Cushing syndrome,Subclinical,hypercortisolism,Adrenal CT,Adrenal imaging,Houndsfield units},
  language     = {eng},
  number       = {1},
  pages        = {164--173},
  publisher    = {Humana Press},
  series       = {Endocrine},
  title        = {Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden},
  url          = {http://dx.doi.org/10.1007/s12020-012-9622-2},
  volume       = {42},
  year         = {2012},
}