Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

A Case-Based Guide to Clinical EndocrinologyCushing’s Syndrome

A Case-Based Guide to Clinical Endocrinology: Cushing’s Syndrome Chapter 16 Lynn Loriaux Objective To illustrate the absolute necessity of defining the source of adrenocorticotropin (ACTH) secretion in cases of ACTH-dependent Cushing’s syndrome. Case Presentation A 24-year-old woman was admitted with Cushing’s disease that had failed to be cured by transsphenoidal microadenectomy at another hospital. Her doctors had recommended she consider pituitary radiation therapy or bilateral adrenalectomy. She asked for a second opinion. The patient was in excellent health until her 21st year, when she began gaining weight in spite of a rigorous exercise and diet program. The diagnosis of Cushing’s syndrome was entertained, and urinary free cortisol was measured. It was found to be between 460 and 800 g/day on three different occasions. A diagnosis of Cushing’s syndrome was made. A dexamethasone-suppression test, 0.5 mg/q.i.d. × 2 days, and 2 mg/q.i.d. for 2 days suppressed the urinary Porter Silber chromogens from a baseline of 18 mg/day to 5.4 mg/day on the last day of the test. This test was interpreted as suggestive of an ACTH secreting pituitary adenoma, and a computed tomography (CT) scan of the sella turcica was done. A 6-mm pituitary microade- noma was visualized. On the basis of these findings, a transsphenoidal microadenec- tomy http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyCushing’s Syndrome

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Loriaux, Lynn
A Case-Based Guide to Clinical Endocrinology — Jan 1, 2008
Download PDF
2 pages

Loading next page...
 
/lp/springer-journals/a-case-based-guide-to-clinical-endocrinology-cushing-s-syndrome-w8e0H0XfB0
Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
159 –161
DOI
10.1007/978-1-60327-103-5_16
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 16 Lynn Loriaux Objective To illustrate the absolute necessity of defining the source of adrenocorticotropin (ACTH) secretion in cases of ACTH-dependent Cushing’s syndrome. Case Presentation A 24-year-old woman was admitted with Cushing’s disease that had failed to be cured by transsphenoidal microadenectomy at another hospital. Her doctors had recommended she consider pituitary radiation therapy or bilateral adrenalectomy. She asked for a second opinion. The patient was in excellent health until her 21st year, when she began gaining weight in spite of a rigorous exercise and diet program. The diagnosis of Cushing’s syndrome was entertained, and urinary free cortisol was measured. It was found to be between 460 and 800 g/day on three different occasions. A diagnosis of Cushing’s syndrome was made. A dexamethasone-suppression test, 0.5 mg/q.i.d. × 2 days, and 2 mg/q.i.d. for 2 days suppressed the urinary Porter Silber chromogens from a baseline of 18 mg/day to 5.4 mg/day on the last day of the test. This test was interpreted as suggestive of an ACTH secreting pituitary adenoma, and a computed tomography (CT) scan of the sella turcica was done. A 6-mm pituitary microade- noma was visualized. On the basis of these findings, a transsphenoidal microadenec- tomy

Published: Jan 1, 2008

Keywords: Pituitary Adenoma; Plasma ACTH; Urinary Free Cortisol; ACTH Secretion; Bilateral Adrenalectomy

There are no references for this article.