Zhong Yuan, Zhang Tao, Li Fan, Chen Yong, Tong Liwei, Xia Chenxi, Wei Dong
Department of Endocrinology, Chengdu Second People's Hospital, Chengdu, China.
Department of Medical Imaging, Chengdu Second People's Hospital, Chengdu, China.
Front Endocrinol (Lausanne). 2024 Dec 16;15:1383987. doi: 10.3389/fendo.2024.1383987. eCollection 2024.
A 51-year-old female patient with diabetes mellitus and hypertension, exhibiting poor control of blood sugar and blood pressure, was unexpectedly found to have multiple large adrenal nodules, excessive cortisol secretion, and adrenocorticotropic hormone inhibition. Cortisol levels remained unresponsive to both low-dose and high-dose dexamethasone tests, leading to a diagnosis of primary bilateral macronodular adrenal hyperplasia. Concurrently, elevated blood calcium and parathyroid hormone levels, along with 99mTc-methoxyisobutyl isonitrile (99mTc-MIBI) imaging revealing increased 99mTc-MIBI uptake in the right inferior parathyroid gland, suggest the consideration of primary hyperparathyroidism. This case is presented in light of the uncommon clinical coexistence of primary bilateral macronodular adrenal hyperplasia and primary hyperparathyroidism.
一名51岁患有糖尿病和高血压的女性患者，血糖和血压控制不佳，意外发现有多个肾上腺大结节、皮质醇分泌过多以及促肾上腺皮质激素抑制。皮质醇水平对低剂量和高剂量地塞米松试验均无反应，导致诊断为原发性双侧大结节性肾上腺增生。同时，血钙和甲状旁腺激素水平升高，以及99m锝-甲氧基异丁基异腈（99mTc-MIBI）显像显示右下甲状旁腺99mTc-MIBI摄取增加，提示考虑原发性甲状旁腺功能亢进。鉴于原发性双侧大结节性肾上腺增生和原发性甲状旁腺功能亢进罕见的临床共存情况，现展示此病例。
