Journal of Yeungnam Medical Science

Case report

Endocrinology, Diabetes, and Metabolism
Bilateral adrenal adenomas with autonomous cortisol secretion from both glands and autonomous aldosterone secretion from the left adrenal: a case report: Jung Eun Han, Soyeon Yoo, Sang Ah Lee, Gwanpyo Koh; J Yeungnam Med Sci. 2025;42:33. Published online April 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.33

Abstract PDF: Primary aldosteronism (PA) is the most common cause of secondary hypertension and increases the morbidity and mortality associated with cardiovascular diseases. When PA coexists with autonomous cortisol secretion (ACS), the cardiovascular risk increases significantly, especially in cases of bilateral adrenal adenomas with asymmetric hormone secretion, which poses diagnostic and therapeutic challenges. A 50-year-old female presented with hypertension and hypokalemia. PA was diagnosed based on elevated aldosterone levels, suppressed plasma renin activity, and the results of various dynamic endocrine tests. Imaging revealed bilateral adrenal adenomas, and adrenal venous sampling (AVS) confirmed aldosterone hypersecretion from the left adrenal gland and cortisol hypersecretion from both adrenal glands. The patient subsequently underwent left adrenalectomy, which resolved the aldosterone hypersecretion and normalized blood pressure and potassium levels. However, the cortisol hypersecretion persisted. This case highlights the importance of AVS in identifying the sources of hormone secretion and enabling targeted surgical treatment while avoiding bilateral adrenalectomy, which can lead to lifelong adrenal insufficiency. Comprehensive endocrine evaluation, including ACS assessment, in patients with PA is essential to help reduce the cardiovascular risks associated with PA and ACS and thus improve treatment outcomes.

Case Report

Nephrology
Page kidney after botulinum toxin injection during chiropractic care.: Han Min Park, Chung Jo Choi, Jin Hee Kim, Ja Kyung Kim, Bum Jun Kim, Jae Yong Seo, Yong Seol Jeong, Jwa Kyung Kim, Sung Gyun Kim; Yeungnam Univ J Med. 2015;32(2):143-145. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.143

Abstract PDF: Page kidney refers to the phenomenon of hypertension secondary to long-standing compression of renal parenchyma caused by renal subcapsular collection. The most common cause of renal subcapsular collection is a hematoma which usually occurs after a history of blunt trauma. A 42-year-old female patient who received botulinum toxin injection in her back during chiropractic care was admitted to the emergency room with sudden bilateral flank pain and hypertension. The computed tomography (CT) images demonstrated the presence of bilateral subcapsular renal hematoma. The patient was treated conservatively and recovered well. The follow up CT images showed markedly resolved bilateral hematoma.

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