Co-Occurrence of Exogenous and Endogenous Cushing’s Syndromes—Dilemma in Diagnosis
المؤلفون المشاركون
Tong, Chin Voon
Rajoo, Subashini
المصدر
العدد
المجلد 2019، العدد 2019 (31 ديسمبر/كانون الأول 2019)، ص ص. 1-3، 3ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2019-10-13
دولة النشر
مصر
عدد الصفحات
3
التخصصات الرئيسية
الملخص EN
Approach to patients who manifest with features of Cushing’s syndrome often begin with exclusion of exposure to excessive exogenous source of glucocorticoids (GC).
Most guidelines advocate no further assessment if excessive exogenous GC use is present.
We present a case of a 66-year-old lady who was noted to have typical features of Cushing’s syndrome.
As she gave a very clear history of ingesting exogenous GC for a year, no further work up was undertaken.
Despite cessation of GC for a year, she continued to have thin skin and easy bruising.
Upon admission for hypertensive emergency, her clinician took note of her changes and investigated her for endogenous Cushing’s syndrome.
Her cortisol post overnight dexamethasone suppression test was 707 nmol/l.
Post low dose dexamethasone suppression test yielded a cortisol of 1133.2 nmol/l.
24 hours urine cortisol was 432.2 nmol/l.
Plasma ACTH was 1.1 pmol/l, indicating an ACTH independent Cushing’s syndrome.
We proceeded with Computed tomography scan (CT scan) of adrenals which revealed a right adrenal adenoma measuring 4.4 × 3.4 × 4.0 cm.
Right retroperiteneoscopic adrenalectomy was done.
Histopathology examination was consistent with adrenal cortical adenoma with foci of myelolipoma.
Post adrenalectomy she developed hypocortisolism secondary to contralateral adrenal suppression which lasted up to the present date.
Her cutaneous and musculoskeletal manifestations improved substantially.
Co-occurrence of endogenous and exogenous Cushing’s syndromes is uncommon but should be considered in patients whose Cushingnoid features do not resolve after cessation of exogenous GC.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Tong, Chin Voon& Rajoo, Subashini. 2019. Co-Occurrence of Exogenous and Endogenous Cushing’s Syndromes—Dilemma in Diagnosis. Case Reports in Endocrinology،Vol. 2019, no. 2019, pp.1-3.
https://search.emarefa.net/detail/BIM-1135707
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Tong, Chin Voon& Rajoo, Subashini. Co-Occurrence of Exogenous and Endogenous Cushing’s Syndromes—Dilemma in Diagnosis. Case Reports in Endocrinology No. 2019 (2019), pp.1-3.
https://search.emarefa.net/detail/BIM-1135707
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Tong, Chin Voon& Rajoo, Subashini. Co-Occurrence of Exogenous and Endogenous Cushing’s Syndromes—Dilemma in Diagnosis. Case Reports in Endocrinology. 2019. Vol. 2019, no. 2019, pp.1-3.
https://search.emarefa.net/detail/BIM-1135707
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1135707
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر