Intraadrenal adrenocorticotropin production in a case of bilateral macronodular @entity774 causing XXXX .

@entity4545 @entity1373 @entity699 @entity774
Adrenochromaffin cells have been shown to physiologically synthesize and secrete @entity4545 . We have thus hypothesized that excessive intraadrenal @entity4545 production may be involved in the pathogenesis of primary @entity699 . In this report we describe a case of @entity699 due to bilateral adrenocortical macronodular @entity1373 associated with suppression of plasma @entity4545 levels. HPLC analysis of adrenal tissue extracts revealed the presence of a peptide coeluting with bioactive @entity4545 . Immunohistochemical studies showed that @entity4545 immunoreactivity was detectable in a subpopulation of steroidogenic cells, but not in chromaffin cells. @entity4545 -positive cells were also labeled by antibodies against relaxin-like factor, a marker of Leydig cells. The presence of @entity4545 in the hyperplastic tissue resulted from local expression of the gene encoding the @entity4545 precursor proopiomelanocortin. Finally, @entity1373 fragments, contrary to normal adrenal cortex explants, appeared to release in vitro measurable amounts of @entity4545 . In conclusion, this observation shows that @entity699 associated with suppressed plasma @entity4545 levels may be dependent upon @entity4545 produced within adrenocortical tissue. The term @entity4545 -independent used to designate primary @entity699 may therefore be inappropriate in some cases of bilateral macronodular @entity774 with @entity699 and undetectable plasma @entity4545 levels.
