{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:14:12Z","timestamp":1788156852116,"version":"build-2803163510"},"reference-count":12,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Possible unrecognized cortisol autonomy in primary aldosteronism may suppress the hypothalamic\u2013pituitary\u2013adrenal axis. Under physiological stress, this may contribute to secondary adrenal insufficiency and severe hyponatremia. Clinicians should consider adrenal insufficiency in patients with primary aldosteronism presenting with unexplained clinical deterioration.<\/jats:p>","DOI":"10.1002\/ccr3.73303","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T05:13:29Z","timestamp":1786166009000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary Adrenal Insufficiency Presenting With Severe Hyponatremia in an Elderly Patient With Primary Aldosteronism Suggesting Underlying Autonomous Cortisol Secretion"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5965-0951","authenticated-orcid":false,"given":"Minami","family":"Toda","sequence":"first","affiliation":[{"name":"Department of Internal Medicine JCHO Saitama Northern Medical Center  Saitama Japan"},{"name":"Department of Nephrology and Hypertension Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine JCHO Saitama Northern Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honami","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine JCHO Saitama Northern Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine JCHO Saitama Northern Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akito","family":"Maeshima","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02775.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002510"},{"key":"e_1_2_11_5_1","first-page":"833","article-title":"Subclinical Cushing's Syndrome in Adrenal Incidentalomas","volume":"26","author":"Terzolo M.","year":"2005","journal-title":"Endocrine Reviews"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-2722"},{"key":"e_1_2_11_7_1","first-page":"107","article-title":"Observational Study Mortality in Adrenal Incidentaloma With Autonomous Cortisol Secretion","volume":"171","author":"Reincke M.","year":"2019","journal-title":"Annals of Internal Medicine"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-024-00984-y"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvad066"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1710"},{"key":"e_1_2_11_11_1","first-page":"418","article-title":"Unique Cases of Aldosterone\u2010 and Cortisol\u2010Producing Adrenal Adenoma","volume":"102","author":"Omura M.","year":"2017","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"e_1_2_11_12_1","first-page":"123","article-title":"Aldosterone\u2010 and Cortisol\u2010Producing Adrenal Adenoma (CAPA): Pathological Features","volume":"29","author":"Aiba M.","year":"2018","journal-title":"Endocrine Pathology"},{"key":"e_1_2_11_13_1","first-page":"1113","article-title":"Immunohistochemical, Genetic and Clinical Characterization of CAPA","volume":"66","author":"Monticone S.","year":"2015","journal-title":"Hypertension"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73303","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73303","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:22:36Z","timestamp":1788153756000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":12,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ccr3.73303"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73303","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73303"}}