Propranolol Therapy for Ectopic β-Adrenergic Receptors in Adrenal Cushing's Syndrome

Most patients with corticotropin-independent Cushing's syndrome have an adrenal adenoma or carcinoma,1 but a few have bilateral adrenal hyperplasia. Three patients with Cushing's syndrome and corticotropin-independent bilateral adrenal hyperplasia2–4 and two patients with adrenal adenomas5,6 in whom food stimulated cortisol secretion have been described; the abnormal adrenal tissues in these patients aberrantly overexpressed receptors for gastric inhibitory polypeptide.6,7 We describe a patient with Cushing's syndrome and corticotropin-independent bilateral adrenal hyperplasia in whom endogenous catecholamines, acting through an ectopic adrenal β-adrenergic receptor, stimulated cortisol secretion; the hyperadrenocorticism was inhibited by β-blockade. Case Report A 56-year-old man presented with . . .