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Modern Management of Mild Autonomous Cortisol Secretion
Author(s) -
Delivanis Danae A.,
Athimulam Shobana,
Bancos Irina
Publication year - 2019
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1551
Subject(s) - disease , medicine , adrenalectomy , secretion , intensive care medicine , bioinformatics , biology
Incidentally discovered adrenal tumors are reported in ~ 5% of adults undergoing cross‐sectional imaging. Mild autonomous cortisol secretion ( MACS ) from the adrenal mass is demonstrated in 5–48% of patients with adrenal tumors. The diagnosis of MACS represents a challenge due to limitations of the currently used diagnostic tests, differences in the definitions of the clinically relevant MACS , and heterogeneity in an individual's susceptibility to abnormal cortisol secretion from the adrenal mass. Patients with MACS present with increased risk of cardiovascular risk factors, cardiovascular events, metabolic bone disease, and mortality. Adrenalectomy improves or reverses MACS ‐associated comorbidities in selected patients. The current review will address diagnostic and management challenges in the care of patients with MACS , discuss data on emerging biomarkers, and suggest future directions in the field of MACS .