ABSTRACT
Two cases of corticosterone-secreting adrenal adenomata are reported. Both patients were middle-aged females in whom the clinical course spanned several years before the diagnosis was made. Severe hypertension and recurrent hypokalaemia refractory to standard treatments were outstanding features. The importance of measuring the production rates of all mineralocorticoids when a tumour is suspected is emphasized by Case 1 where the production rate of corticosterone alone was elevated. Bilateral renal artery stenosis was responsible for unsuppressed plasma renin activity in Case 2.
Subject(s)
Adenoma/metabolism , Adrenal Gland Neoplasms/metabolism , Corticosterone/metabolism , Renal Artery Obstruction/complications , Adrenal Gland Neoplasms/complications , Adult , Aldosterone/metabolism , Corticosterone/adverse effects , Female , HumansABSTRACT
A patient with Addison's disease required increased corticosteroid dosage whilst receiving rifampicin. The pharmacological half-life of cortisol was reduced, but returned to normal when rifampicin was stopped. Cortisolproduction rates in four patients with pulmonary tuberculosis rose during treatment with rifampicin, as did urinary D-glucaric-acid excretion, an index of liver microsomal-enzyme activity. The alteration of the corticosteroid requirement in the patient with Addison's disease and the elevation of the cortisol-production rates were attributed to increased cortisol catabolism following hepatic macrosomal-enzyme induction by rifampicin.
