{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:24:53Z","timestamp":1775121893487,"version":"3.50.1"},"reference-count":19,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Adrenocortical carcinoma (ACC) is a rare malignancy often associated with disorganized steroid synthesis, leading to variable clinical phenotypes. Etomidate, an imidazole derivative, is a potent inhibitor of adrenal cytochrome P450-dependent enzymes, particularly 11\u03b2-hydroxylase (CYP11B1). Subhypnotic doses of etomidate are effective in reducing serum cortisol in patients with severe Cushing syndrome, a common manifestation in ACC. However, the effects of etomidate on other adrenal hormones in ACC remain poorly understood. In this report, we measured 13 steroid hormones before and after etomidate infusion using liquid chromatography-tandem mass spectrometry in a patient with ACC. Etomidate administration led to marked suppression of cortisol and aldosterone, while 11-deoxycorticosterone levels increased substantially. Interestingly, despite the elevated 11-deoxycorticosterone, serum potassium normalized, highlighting a complex interplay among mineralocorticoid precursors and active hormones in maintaining electrolyte balance.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf335","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:42:31Z","timestamp":1767789751000},"source":"Crossref","is-referenced-by-count":0,"title":["Normalization of Potassium Despite 11-Deoxycorticosterone Rise During Etomidate Therapy in Adrenocortical Carcinoma"],"prefix":"10.1210","volume":"4","author":[{"given":"Olivia","family":"Bhattacharya","sequence":"first","affiliation":[{"name":"Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research , Kolkata 700020, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3903-1376","authenticated-orcid":false,"given":"Arijit","family":"Singha","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research , Kolkata 700020, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhasis","family":"Neogi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research , Kolkata 700020, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhankar","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research , Kolkata 700020, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"1","key":"2026040204224610200_luaf335-B1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1586\/17446651.2016.1123615","article-title":"Current strategies for the treatment of severe Cushing's syndrome","volume":"11","author":"Alexandraki","year":"2016","journal-title":"Expert Rev Endocrinol Metab"},{"issue":"3","key":"2026040204224610200_luaf335-B2","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1007\/s12020-024-04135-1","article-title":"Is there still a place for etomidate in the management of Cushing's syndrome? The experience of a single center of low-dose etomidate and combined etomidate-osilodrostat treatment in severe hypercortisolemia","volume":"87","author":"Dzialach","year":"2025","journal-title":"Endocrine"},{"issue":"22","key":"2026040204224610200_luaf335-B3","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1056\/NEJM198405313102202","article-title":"Inhibition of adrenal steroidogenesis by the anesthetic etomidate","volume":"310","author":"Wagner","year":"1984","journal-title":"N Engl J Med"},{"issue":"2","key":"2026040204224610200_luaf335-B4","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1530\/EJE-12-0274","article-title":"Etomidate in the management of hypercortisolaemia in Cushing's syndrome: a review","volume":"167","author":"Preda","year":"2012","journal-title":"Eur J Endocrinol"},{"key":"2026040204224610200_luaf335-B5","doi-asserted-by":"crossref","first-page":"20420188211058583","DOI":"10.1177\/20420188211058583","article-title":"Pharmacological management of severe Cushing's syndrome: the role of etomidate","volume":"13","author":"Pence","year":"2022","journal-title":"Ther Adv Endocrinol Metab"},{"issue":"4","key":"2026040204224610200_luaf335-B6","doi-asserted-by":"crossref","first-page":"bvaf039","DOI":"10.1210\/jendso\/bvaf039","article-title":"Etomidate in severe cushing syndrome: a systematic review","volume":"9","author":"Muthukuda","year":"2025","journal-title":"J Endocr Soc"},{"issue":"1","key":"2026040204224610200_luaf335-B7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1210\/js.2018-00269","article-title":"Continuous etomidate infusion for the management of severe cushing syndrome: validation of a standard protocol","volume":"3","author":"Carroll","year":"2019","journal-title":"J Endocr Soc"},{"issue":"1","key":"2026040204224610200_luaf335-B8","doi-asserted-by":"crossref","first-page":"102","DOI":"10.4274\/jcrpe.galenos.2020.2020.0164","article-title":"Using etomidate in a two-month-old infant with cushing syndrome due to adrenocortical carcinoma","volume":"14","author":"Kwon","year":"2022","journal-title":"J Clin Res Pediatr Endocrinol"},{"issue":"6","key":"2026040204224610200_luaf335-B9","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1258\/acb.2010.010167","article-title":"Cortisol measurement in patients receiving metyrapone therapy","volume":"47","author":"Owen","year":"2010","journal-title":"Ann Clin Biochem"},{"key":"2026040204224610200_luaf335-B10","first-page":"EDM190044","article-title":"Etomidate in the management of severe Cushing's disease and MRSA bacteraemia in a district general hospital in the United Kingdom","volume":"2019","author":"Wong","year":"2019","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2026040204224610200_luaf335-B11","doi-asserted-by":"crossref","first-page":"846865","DOI":"10.3389\/fendo.2022.846865","article-title":"11-Deoxycorticosterone producing adrenal hyperplasia as a very unusual cause of endocrine hypertension: case report and systematic review of the literature","volume":"13","author":"Asla","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"2","key":"2026040204224610200_luaf335-B12","doi-asserted-by":"crossref","first-page":"luae015","DOI":"10.1210\/jcemcr\/luae015","article-title":"Prolonged hypokalemia following metyrapone treatment for primary bilateral macronodular adrenal cortical disease","volume":"2","author":"Kidawara","year":"2024","journal-title":"JCEM Case Rep"},{"issue":"3","key":"2026040204224610200_luaf335-B13","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.beem.2006.07.006","article-title":"Hypertension in Cushing's syndrome","volume":"20","author":"Magiakou","year":"2006","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"1","key":"2026040204224610200_luaf335-B14","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1530\/JOE-11-0178","article-title":"The mislabelling of deoxycorticosterone: making sense of corticosteroid structure and function","volume":"211","author":"Vinson","year":"2011","journal-title":"J Endocrinol"},{"issue":"6","key":"2026040204224610200_luaf335-B15","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1159\/000324419","article-title":"Use of intravenous etomidate to control acute psychosis induced by the hypercortisolaemia in severe paediatric Cushing's disease","volume":"75","author":"Chan","year":"2011","journal-title":"Horm Res Paediatr"},{"issue":"3","key":"2026040204224610200_luaf335-B16","first-page":"140","article-title":"Efficient short-term control of hypercortisolaemia by low-dose etomidate in severe paediatric Cushing's disease","volume":"64","author":"Greening","year":"2005","journal-title":"Horm Res"},{"key":"2026040204224610200_luaf335-B17","doi-asserted-by":"crossref","first-page":"1060884","DOI":"10.3389\/fendo.2022.1060884","article-title":"Individualized medical treatment options in Cushing disease","volume":"13","author":"Gilis-Januszewska","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2026040204224610200_luaf335-B18","first-page":"255","article-title":"Ectopic Cushing syndrome: report of 9 cases. S\u00edndrome de Cushing ect\u00f3pico: descripci\u00f3n de 9 casos","volume":"65","author":"Araujo Castro","year":"2018","journal-title":"Endocrinol Diabetes Nutr (Engl Ed)"},{"issue":"4","key":"2026040204224610200_luaf335-B19","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1097\/00000542-200310000-00022","article-title":"Activation of alpha 2B-adrenoceptors mediates the cardiovascular effects of etomidate","volume":"99","author":"Paris","year":"2003","journal-title":"Anesthesiology"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/4\/luaf335\/67720999\/luaf335.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/4\/luaf335\/67720999\/luaf335.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T08:22:54Z","timestamp":1775118174000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf335\/8572036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,3,19]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf335","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,3,19]]},"article-number":"luaf335"}}