ArticleThe Journal of clinical endocrinology and metabolism2011
Clinical, biochemical, and molecular characterization of macronodular adrenocortical hyperplasia of the zona reticularis: a new syndrome.
Article in The Journal of clinical endocrinology and metabolism, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women.Clinical endocrinology · 2025Guideline
- Advancements in the research of the structure, function, and disease-related roles of ARMC5.Frontiers of medicine · 2025Review
- Bilateral macronodular adrenocortical disease: a single centre experience.Endocrine connections · 2025Article
- Case Report: Adrenocortical adenoma harboring atypical subclinical Cushing's syndrome with dehydroepiandrosterone sulfate transferase and cytochrome b5 expression in tumor cells.Frontiers in endocrinology · 2025Article
- Molecular and Genetics Perspectives on Primary Adrenocortical Hyperfunction Disorders.International journal of molecular sciences · 2024Review
- Primary unilateral macronodular adrenal hyperplasia with concomitant glucocorticoid and androgen excess and KDM1A inactivation.European journal of endocrinology · 2024Article
- Development of Human Adrenocortical Adenoma (HAA1) Cell Line from Zona Reticularis.International journal of molecular sciences · 2022Article
- Characterization of Adrenal miRNA-Based Dysregulations in Cushing's Syndrome.International journal of molecular sciences · 2022Article
- Article
- [The 2017 WHO classification of pituitary tumors].Der Pathologe · 2021Article
- Steroid Metabolome Analysis in Disorders of Adrenal Steroid Biosynthesis and Metabolism.Endocrine reviews · 2019Article
- Mouse models of adrenocortical tumors.Molecular and cellular endocrinology · 2016Review
- Development of adrenal cortex zonation.Endocrinology and metabolism clinics of North America · 2015Review
- Steroidogenic enzyme profile in an androgen-secreting adrenocortical oncocytoma associated with hirsustism.Endocrine connections · 2015Article
- Cell-to-cell communication in bilateral macronodular adrenal hyperplasia causing hypercortisolism.Frontiers in endocrinology · 2015Review
- Functional studies of p.R132C, p.R149C, p.M283V, p.E431K, and a novel c.652-2A>G mutations of the CYP21A2 gene.PloS one · 2014Article
- Adrenal incidentaloma imaging - the first steps in therapeutic management.Polish journal of radiology · 2013Review
- cAMP/PKA signaling defects in tumors: genetics and tissue-specific pluripotential cell-derived lesions in human and mouse.Molecular and cellular endocrinology · 2013Review
- Aged PROP1 deficient dwarf mice maintain ACTH production.PloS one · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
contextMacronodular adrenocortical hyperplasia classically presents with progressive hypercortisolemia and Cushing syndrome. We describe a 29-yr-old man with massive macronodular adrenocortical hyperplasia without hypercortisolemia but rather markedly elevated and nonsuppressible production of dehydroepiandrosterone (DHEA) and its sulfate (DHEAS).
objectiveTo characterize the clinical and molecular features of this case and to determine whether the tissue biochemically resembles the zona reticularis or fetal adrenal.
settingUniversity clinic, hospital, and laboratories.
designStatic and dynamic blood and urine testing were performed preoperatively. Tissue was studied by light microscopy, immunoblot, RNA microarray, and enzyme assay. PARTICIPANT: A 29-yr-old man with incidentally discovered bilateral adrenal enlargement.
interventionBilateral adrenalectomy.
main outcome measuresMolecular studies compared with control samples.
resultsHypercortisolism and 21-hydroxylase deficiency were excluded. DHEA, DHEAS, and 17-hydroxypregnenolone were markedly elevated and did not suppress with dexamethasone 2 mg/d for 4 d. Homogenates of the adrenals demonstrated high 17-hydroxylase, good 17,20-lyase, and low or absent 21-hydroxylase and 3β-hydroxysteroid dehydrogenase activities. Immunoblots confirmed robust expression of cytochrome P450c17 and AKR1C3 but not P450c21. Microarray analysis demonstrated high CYP11A1 and CYP17A1 expression but low or absent HSD3B1, HSD3B2, and CYP21A2 expression. Expression of mRNA for cytochrome b(5) (CYB5A) and AKR1C3, markers of the zona reticularis, were markedly elevated.
conclusionThis is the first case of macronodular hyperplasia of the adrenal zona reticularis confirmed with studies of enzyme activity, mRNA expression, and protein identification. We speculate that this condition can be clinically silent in men but might cause severe hyperandrogenemia in women.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.