{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T15:52:43Z","timestamp":1740153163306,"version":"3.37.3"},"reference-count":19,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>A 41-year-old woman presented to the hospital because of left flank pain. CT scan of the kidneys revealed left-sided calculi and an incidental right adrenal mass, no other symptoms noted. She then underwent shockwave lithotripsy (SWL). However, immediately postoperatively, she had elevated blood pressure and remained hypertensive despite having four different medications. How SWL could have increased blood pressure could not be identified. On endocrine consult 16 months after SWL, she was found to now exhibit signs and symptoms of Cushing\u2019s syndrome. Further workup revealed the adrenal incidentaloma to be cortisol-secreting. After undergoing right laparoscopic adrenalectomy, her blood pressure normalised, cortisol levels decreased and signs of Cushing\u2019s syndrome gradually improved. We hypothesise that the performance of the SWL could have triggered the adenoma to \u2018awaken\u2019 from being non-functioning to cortisol-producing since this was the only intervening event. Observations of other patients are needed to validate our hypothesis.<\/jats:p>","DOI":"10.1136\/bcr-2020-235261","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T05:35:15Z","timestamp":1598420115000},"page":"e235261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Resistant hypertension after shockwave lithotripsy: the rude awakening of an adrenal incidentaloma"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4538-416X","authenticated-orcid":false,"given":"Ramon Jr Bagaporo","family":"Larrazabal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harold Henrison Chang","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-8287","authenticated-orcid":false,"given":"Mark Anthony Santiago","family":"Sandoval","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"2020082522350626000_13.8.e235261.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-5-200303040-00013"},{"key":"2020082522350626000_13.8.e235261.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03344099"},{"key":"2020082522350626000_13.8.e235261.3","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.12688\/f1000research.11766.1","article-title":"Case Report: An incidentaloma that catches your eye - adrenal myelolipoma","volume":"6","author":"D'Addosio","year":"2017","journal-title":"F1000Res"},{"key":"2020082522350626000_13.8.e235261.4","doi-asserted-by":"crossref","unstructured":"Pasternak J , Seib C , Seiser N , et al . 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