ArticleEndocrine2022
The role of adrenal venous sampling (AVS) in primary bilateral macronodular adrenocortical hyperplasia (PBMAH): a study of 16 patients.
Article in Endocrine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 26 citations in OpenAlex.
- Genetic background and management outcomes in primary bilateral macronodular adrenal hyperplasia: Implications for diagnosis and treatment-A retrospective cohort study.The Journal of international medical research · 2026Article
- Primary bilateral macronodular adrenal hyperplasia presenting as resistant hypertension with bilateral adrenal masses: a case report.Annals of medicine and surgery (2012) · 2026Article
- Adrenal Venous Sampling Aids in Distinguishing 17-Hydroxyprogesterone Hypersecreting Adrenal Cortical Adenomas from Non-Classical 21-Hydroxylase Deficiency.Diagnostics (Basel, Switzerland) · 2026Article
- Primary Bilateral Macronodular Adrenal Hyperplasia Associated WithJCEM case reports · 2026Article
- Bilateral Adrenalectomy for Primary Bilateral Macronodular Adrenocortical Hyperplasia With a NovelJournal of clinical medicine research · 2025Article
- Utility of Adrenal Vein Sampling to Guide Surgical Management of Hypercortisolism.Case reports in endocrinology · 2024Article
- Endocrine causes of hypertension: literature review and practical approach.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Review
- Article
- ARMC5-negative primary bilateral macronodular adrenal hyperplasia.BMJ case reports · 2023Article
- Primary bilateral macronodular adrenocortical hyperplasia (PBMAH) patient with ARMC5 mutations.BMC endocrine disorders · 2023Article
- The role of adrenal venous sampling (AVS) in primary bilateral macronodular adrenocortical hyperplasia (PBMAH): a study of 16 patients.Endocrine · 2022Article
- Steroid profiling using liquid chromatography mass spectrometry during adrenal vein sampling in patients with primary bilateral macronodular adrenocortical hyperplasia.Frontiers in endocrinology · 2022Article
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Authors and funding
16 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePrimary bilateral macronodular adrenocortical hyperplasia (PBMAH) is a rare cause of ACTH-independent Cushing's syndrome. Current guidelines recommend bilateral adrenalectomy for PBMAH, but several studies showed clinical effectiveness of unilateral adrenalectomy despite bilateral disease in selected patients. Our aim was to evaluate the gain of information which can be obtained through adrenal venous sampling (AVS) based cortisol lateralization ratios for guidance of unilateral adrenalectomy.
designWe performed a retrospective analysis of 16 patients with PBMAH and clinical overt cortisol secretion in three centers
methodsSelectivity of adrenal vein sampling during AVS was defined as a gradient of cortisol or a reference adrenal hormone ≥2.0 between adrenal and peripheral vein. Lateralization was assumed if the dominant to non-dominant ratio of cortisol to reference hormone was ≥4.0.
resultsAVS was technically successful in all patients based on absolute cortisol levels and in 13 of 16 patients (81%) based on reference hormone levels. Lateralization was documented in 8 of 16 patients. In patients with lateralization, in 5 of 8 cases this occurred toward morphologically larger adrenals, while in 3 patients lateralization was present in bilaterally identical adrenals. The combined volume of adrenals correlated positively with urinary free cortisol, suggesting that adrenal size is the dominant determinant of cortisol secretion.
conclusionsIn this study the gain of information through AVS for unilateral adrenalectomy was limited in patients with PBMAH and marked adrenal asymmetry.
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