@article{oai:jichi-ir.repo.nii.ac.jp:00000042,
 author = {山田, 穂高 and 佐々木, 正美 and 浅野, 智子 and 青木, 厚 and 生駒, 亜希 and 豊島, 秀男 and 加計, 正文 and 川上, 正舒 and 石川, 三衛},
 journal = {自治医科大学紀要, Jichi Medical University Journal},
 month = {Mar},
 note = {68歳男性。入院４年前から両側下肢筋力低下が出現，３年前から近医で糖尿病，高血圧を指摘され加療を受けていた。高血圧のスクリーニングで撮像した腹部CT で両側副腎の多結節状腫大を指摘され，当科を紹介受診した。血清コルチゾール34.9μg/dL，デキサメサゾンでの抑制なく，クッシング症候群が考えられ，精査目的に入院となった。入院時の身体所見では明らかなクッシング兆候は見られなかった。精査の結果ACTH 非依存性両側副腎皮質大結節性過形成（AIMAH）によるクッシング症候群と診断した。バソプレシンによるコルチゾールの分泌亢進が認められ，AIMAH 組織内のバソプレシン受容体発現が強く推察された。, A 68-year-old man was admitted for evaluation of Cushing’s syndrome. He complained of muscular weakness 4 years previously,and had been treated for diabetes mellitus and hypertension for 3 years. A local physician noted bilateral adrenal enlargement on an abdominal CT scan. On admission physical examination, no Cushingoid signs were found. Laboratory results included 34.9 μ g/dL serum cortisol and less than 2 pg/mL plasma ACTH. Overnight administration of 0.5 mg dexamethasone did not suppress serum cortisol. An abdominal CT scan depicted bilateral adrenal hyperplasia, 100×50 mm and 80×60 mm, indicating ACTHindependent macronodular adrenocortical hyperplasia (AIMAH）. We suggest that vasopressin receptor may be expressed in the nodular tissues. Because of this patient’s serious concurrent conditions, including paroxysmal atrial fibrillation and herpes zoster, adrenalectomy was not possible during this hospitalization. The present case illustrates that AIMAH left undiagnosed for a long period produces muscular atrophy and reduces anti-inflammatory activity.},
 pages = {101--105},
 title = {著しい筋力低下を認めたACTH 非依存性両側副腎皮質大結節性過形成（AIMAH）の一例},
 volume = {35},
 year = {2013}
}