Occasionally cortisol can cause mineralocorticoid-type hypertension.
Situations where encountered:
(1) ectopic corticotropin secretion
(2) pituitary dependent Cushing's syndrome
Clinical and laboratory findings:
(2) Cushing syndrome
(3) low plasma rennin and aldosterone levels
(4) elevated ratio of tetrahydrocortisol to tetrahydrocortisone in the urine
(5) correction of hypertension by correction of excessive cortisol production
Mechanism: Excessive cortisol may exceed the capacity of renal Type 2 11-beta-hydroxysteroid dehydrogenase (which normally inactivates it to cortisone). Sufficient cortisol is present to bind to mineralocorticoid receptors, resulting in hypertension.
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Purpose: To evaluate a patient with cortisol-associated hypertension.
Objective: clinical diagnosis, including family history for genetics, laboratory tests, criteria for diagnosis
ICD-10: I10, I11, I12, E26.9,