Table 1.
Summary of endocrine disorders of the patient.
| 1st admission | Preoperation | 3 months after operation | The diagnostic criterion of CS/SCS | ||
|---|---|---|---|---|---|
| presence or absence of the physical symptom of Cushing’s syndrome | Absence | Absence | Absence | CS: presence/SCS: absence | |
| Morning plasma ACTH level (pg/mL) | 5.0 | 8.7 | 25.8 | CS: <5.0 pg/mL/SCS: <10.0 pg/mL | |
| Morning serum cortisol level (µg/dL) | 12.60 | 9.01 | 5.62 | CS: normal or high (> 8 µg/dl)/SCS: normal (8–18 µg/dL) | |
| Nocturnal serum cortisol level (µg/dL) | 2.68 | 3.84 | N.A. | CS: <7.5 µg/dL/SCS: < 5.0 µg/dL | |
| Serum cortisol level on 1-mg dexamethasone suppression test (µg/dL) | 0.89 | 1.38 | 0.69 | CS: <5.0 pg/mL/SCS: <1.8 pg/mL | |
| Dehydroepiandrosterone sulphate level (µg/dL) | 28 | 15 | 18 | CS and SCS: < 12 µg/dL (considering patient’s sex and age) | |
| 1st admission | Preoperation | 3 months after operation | The diagnostic criterion of primary aldosteronism | ||
| Baseline ARR | 404 | 381 | 369 | ARR > 200 | |
| Captopril-challenge tests | ARR (60 min) | 56 | 189 | 199 | ARR (60 or 90 min) > 200 |
| ARR (90 min) | 41 | 248 | 182 | ||
| upright furosemide-loading tests | plasma renin activity (120 min) (ng/mL/hr) | 0.9 | 0.9 | 1.2 | Plasma renin activity (120 min) < 2.0 ng/mL/hr |
| Saline-loading test | Plasma aldosterone (240 min) (pg/mL) | 11.1 | <10.0 | 21.4 | Plasma aldosterone (240 min) > 60 pg/mL |
CS, Cushing’s syndrome; SCS, subclinical Cushing’s syndrome; N.A, not assessed; ARR, the ratio of plasma aldosterone concentration/plasma renin activity.