{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:32:22Z","timestamp":1793320342298,"version":"4.5.0"},"reference-count":89,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Clinician Scientist Program RISE"},{"name":"Else-Kr\u00f6ner-Fresenius Stiftung and the Eva Luise und Horst K\u00f6hler Stiftung","award":["2022_EKFKSE.03"],"award-info":[{"award-number":["2022_EKFKSE.03"]}]},{"name":"Else Kr\u00f6ner-Fresenius Stiftung in support of the German Conn's Registry","award":["2013_A182"],"award-info":[{"award-number":["2013_A182"]}]},{"name":"Else Kr\u00f6ner-Fresenius Stiftung in support of the German Conn's Registry","award":["2015_A171"],"award-info":[{"award-number":["2015_A171"]}]},{"name":"Else Kr\u00f6ner-Fresenius Stiftung in support of the German Conn's Registry","award":["2019_A104"],"award-info":[{"award-number":["2019_A104"]}]},{"name":"European Research Council under the European Union Horizon 2020 research and innovation program","award":["694913"],"award-info":[{"award-number":["694913"]}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Research Priority Program of the University of Zurich for the CRPP HYRENE"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Bilateral macronodular adrenal disease (BMAD) typically presents with bilateral benign adrenocortical macronodules and variable cortisol excess. Anecdotal evidence suggests oversecretion of other adrenal steroids, including mineralocorticoids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Hypothesis<\/jats:title>\n                  <jats:p>We hypothesized that primary aldosteronism (PA) can occur in BMAD, resulting in a distinct, more severe phenotype compared to BMAD with isolated cortisol hypersecretion or unilateral PA (uPA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the prevalence and characteristics of PA in BMAD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We systematically reviewed case reports and series of BMAD patients with PA, following PRISMA guidelines. BMAD was defined by bilateral adrenal nodules \u226510\u2005mm. PA diagnosis followed US or Japanese Endocrine Society guidelines. We compared these findings with 2 cohorts from LMU Hospital Munich: BMAD with isolated cortisol hypersecretion and uPA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 1018 articles, 18 representing 68 cases were included. Of these, 66 had BMAD with PA and 2 had BMAD with aldosterone precursor excess. The PA proportion in published BMAD series ranged from 2% to 43%. BMAD patients with PA were predominantly male (75%) and younger (median 51.5 years) than those with isolated cortisol hypersecretion (median 60.5 years, P &amp;lt; .01). Their median blood pressure was higher (170\/100\u2005mm Hg) compared to those with isolated cortisol hypersecretion (138\/80\u2005mm Hg) or uPA (153\/94\u2005mm Hg, P &amp;lt; .01). Treatment was only described in 28 cases, with 93% undergoing adrenalectomy. Clinical outcome was similar across groups post-treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This review highlights the need for increased screening for PA in younger, hypertensive BMAD patients. Larger multicenter studies are needed to determine the association between these conditions, cardiovascular risk, and optimal treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf020","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T19:51:56Z","timestamp":1739908316000},"page":"S15-S25","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and main characteristics of primary aldosteronism in bilateral macronodular adrenal disease: a systematic review of the literature"],"prefix":"10.1093","volume":"192","author":[{"given":"Annalisa","family":"Panarelli","sequence":"first","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]},{"name":"Internal Medicine and Hypertension Division, Department of Medical Sciences, University of Turin , 10124 Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fania Ribeiro de Oliveira Longo","family":"Schweizer","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"St\u00fcfchen","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Br\u00fcdgam","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Zopp","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5480-1116","authenticated-orcid":false,"given":"Paolo","family":"Mulatero","sequence":"additional","affiliation":[{"name":"Internal Medicine and Hypertension Division, Department of Medical Sciences, University of Turin , 10124 Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Deniz","sequence":"additional","affiliation":[{"name":"Department of Radiology, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-3984","authenticated-orcid":false,"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]},{"name":"Department of Endocrinology, Diabetology, and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH) , 8091 Zurich ,","place":["Switzerland"]},{"name":"The LOOP Zurich\u2014Medical Research Center , 8044 Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9817-9875","authenticated-orcid":false,"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich 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