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

Abstract EN

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.