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Primary Pigmented Nodular Adrenocortical Disease

Clinical Genetics Genomics


Primary pigmented nodular adrenocortical disease (PPNAD) is a form of bilateral adrenocortical hyperplasia that is often associated with corticotrophin (ACTH)-independent Cushing’s syndrome (CS) and is characterized by small to normal-sized adrenal glands containing multiple small cortical pigmented nodules.  PPNAD may occur in an isolated form or associated with a multiple neoplasia syndrome, the complex of spotty skin pigmentation, myxomas, and endocrine overactivity, or Carney complex, in which Cushing’s syndrome is the most common endocrine manifestation.

Molecular studies have led to the identification of variants in the ARMC5, PDE11A, PDE8B and PRKAR1A genes (Groussin et al. 2002 J Clin Endocrinol Metab 87:4324–4329; Horvath et al. Nature Genetics 2006 38:794-800; Rothenbuhler et al. 2012 Clin Endocrinol 77:195–199).

The laboratory participates in the European Molecular Genetics Quality Network (EMQN) sequencing scheme.

NHSE test directory code: R160 Primary pigmented nodular adrenocortical disease. Testing criteria can be found on this webpage: https://www.england.nhs.uk/publication/national-genomic-test-directories/.

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