Introduction: An association between primary hyperaldosteronism and autonomous cortisol secretion, tentatively termed Connshing syndrome, is becoming increasingly recognized.
Aim: To present a case of primary hyperaldosteronism associated with ACTH-independent subclinical Cushings.
Methods: Clinical examination, biochemical testing and imaging studies.
Results: A 49-year old hypertensive (max 210 mmHg), obese (BMI=35 kg/m2), normoglycemic female patient without clinical signs of Cushings was screened for secondary hypertension, revealing normokalemia (4.1 mEq/L), an increased plasma aldosterone to renin (PAC/PRC) ratio and unsuppressed PAC during the saline loading test (PAC nadir=10.2 ng/dL,
Conclusion: Subclinical Cushings is possibly underdiagnosed in primary aldosteronism patients, depending on subject selection and tests used for screening of hypercortisolism.