Long-term low-dose @entity3102 treatment in bilateral XXXX .

@entity1 @entity1369 @entity101 @entity5 @entity3102 @entity916 @entity699 @entity134 @entity701 @entity972 @entity1011 @entity10 @entity774
Medical therapy for @entity699 due to bilateral @entity774 (BMAH) is generally administered for a limited time before surgery. Aberrant receptors antagonists show inconsistent efficacy in the long run to prevent adrenalectomy. We present a @entity1 with BMAH, treated for 10 years with low doses of @entity3102 to control @entity701 secretion. A 48-year-old @entity1 presented with @entity10 and @entity101 . Investigations showed the following: no clinical signs of @entity699 ; enlarged lobulated adrenals; normal @entity1011 , @entity972 , and @entity1369 ; normal urinary @entity1369 and metanephrines; elevated urinary free @entity701 and @entity134 metabolites; and suppressed plasma @entity916 activity and ACTH. A screening protocol for aberrant adrenal receptors failed to show any illegitimate hormone dependence. @entity3102 caused rapid normalisation of @entity701 and ACTH that persists over 10 years on treatment, while adrenals show no change in shape or size. @entity3102 decreases @entity701 in @entity1 with @entity699 , and may prevent @entity774 . @entity134 secretion in BMAH is inefficient as compared with normal adrenals or secreting @entity5 and can be controlled with low, well-tolerated doses of @entity3102 , as an alternative to surgery. LEARNING POINTS: Enlarged, macronodular adrenals are often incidentally found during the investigation of @entity101 in @entity1 harboring BMAH. Although laboratory findings include low ACTH and elevated @entity701 , the majority of @entity1 do not display cushingoid features.Bilateral adrenalectomy, followed by life-long @entity134 replacement, is the usual treatment of this benign condition, and alternative medical therapy is sought. Therapy based on aberrant adrenal receptors gives disappointing results, and inhibitors of steroidogenesis are not always well tolerated.However, @entity3102 at low, well-tolerated doses appeared appropriate to control adrenal @entity134 secretion indefinitely, while preventing @entity774 . This treatment probably constitutes the most convenient long-term alternative to surgery.
