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Remission of Cushing's Syndrome After Unilateral Adrenal Phlebography: Apparent Destruction of Adrenal Adenoma

HERBERT FELLERMAN, M.D.; THEODORE G. DALAKOS, M.D.; and DAVID H. P. STREETEN, M.B., D. Phil., F.A.C.P., M.R.C.P.
[+] Article and Author Information

Supported by Graduate Training Grant in Endocrinology AM 05252, National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md.; and Clinical Research Center grant RR 00229, U. S. Public Health Service, Washington, D.C.

▸Requests for reprints should be addressed to D. H. P. Streeten, M.B., Department of Medicine, State University Hospital, 750 E. Adams St., Syracuse, N.Y. 13210


Syracuse, New York


Ann Intern Med. 1970;73(4):585-589. doi:10.7326/0003-4819-73-4-585
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A patient had obvious clinical features of Cushing's syndrome associated with elevated urinary and plasma 17-hydroxycorticoids (17-OHCS) that resisted suppression by dexamethasone, 2 mg every 6 hr. Left-sided adrenal phlebography was followed by epigastric pain, features of adrenal insufficiency, and a fall in plasma and urinary 17-OHCS, with evidence of suppression of adrenocorticotrophic hormone release by the pituitary. Spontaneous loss of all clinical features of Cushing's syndrome was accompanied by a return of plasma and urinary 17-OHCS to normal levels. It is concluded that the adrenal phlebography fortuitously caused subtotal infarction of the adrenal adenoma with remission of hypercortisolism.

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