Imperial College London
Alternate

Professor Karim Meeran

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology
 
 
 
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Contact

 

+44 (0)20 8846 1065k.meeran

 
 
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Location

 

9E05Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Meeran:2021:10.1016/j.aace.2020.11.022,
author = {Meeran, M and Zaman, S},
doi = {10.1016/j.aace.2020.11.022},
journal = {AACE Journal},
pages = {109--112},
title = {The Vanishing Adrenal Glands: A transient regression of adrenal lymphoma after a single dose of 1 mg dexamethasone},
url = {http://dx.doi.org/10.1016/j.aace.2020.11.022},
volume = {7},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: Dexamethasone is a known treatment for lymphoma, but it’s potency and rapidity of its effect has not been recognised. Our objective is to present a case of bilateral adrenal lymphoma, which significantly reduced in size after a single dose of dexamethasone. Methods: Clinical course and investigations  including Adrenocorticotropic hormone (ACTH), cortisol, short synacthen test, computed tomography (CT) and adrenal biopsy are presented.Results: A 52-year-old man had a fall and was incidentally found to have bilateral  adrenal masses (6 cm on left and 5 cm on right) on CT. His adrenal function tests included plasma metanephrines (normetanephrine 830 pmol/L (0-1180); metanephrine <100 pmol/L (0-510); 3-methoxytyramine <100 pmol/L (0-180), aldosterone 270 pmol/L( 90-700) and random cortisol 230 nmol/L (160-550). Overnight dexamethasone suppression test (ONDST), with 1 mg of dexamethasone, showed cortisol of <28 nmol/L (0-50).. A repeat CT, eight days following ONDST, showed adrenal masses of 4.5 cm and 3.5 cm on left and right respectively. He had a follow-up CT three months later, which showed adrenal lesions measuring 8 cm (left) and 9 cm (right). He subsequently presented with fatigue and dizziness. Morning cortisol of 201 nmol/L (160-550) with ACTH of 216 ng/L (10-30)  indicated primary adrenal insufficiency. Mineralocorticoid and glucocorticoid replacement was commenced. Adrenal biopsy showed abnormal enlarged B-cells consistent with a diagnosis of diffuse large B-cell lymphoma. Conclusion: A diagnosis of lymphoma should be considered when adrenal lesions shrink, following even a single low dose of dexamethasone administered as a part of a diagnostic test.
AU  - Meeran,M
AU  - Zaman,S
DO  - 10.1016/j.aace.2020.11.022
EP  - 112
PY  - 2021///
SN  - 1551-3696
SP  - 109
TI  - The Vanishing Adrenal Glands: A transient regression of adrenal lymphoma after a single dose of 1 mg dexamethasone
T2  - AACE Journal
UR  - http://dx.doi.org/10.1016/j.aace.2020.11.022
UR  - https://www.sciencedirect.com/science/article/pii/S2376060520310233
UR  - http://hdl.handle.net/10044/1/85816
VL  - 7
ER  -
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