A 46 year old woman has central obesity, purple abdominal striae, and glucose intolerance. ACTH is low, and serum cortisol is elevated with no suppression after low or high dose dexamethasone. CT scan shows a unilateral adrenal mass. Which of the following is the most likely cause of her disease?
- A)Bilateral adrenal hyperplasia due to ACTH excess
- B)Autonomous cortisol production by an adrenal adenomaGABARITO
- C)Pituitary ACTH excess
- D)Ectopic CRH secretion
- E)Exogenous glucocorticoid administration
Explicação
A unilateral adrenal mass with low ACTH and failure to suppress after dexamethasone indicates ACTH independent Cushing syndrome from autonomous adrenal cortisol production. Excess cortisol suppresses pituitary ACTH, often leading to atrophy of the contralatera... Ver explicação completa e trilha adaptativa →