Cushing-Syndrom bei CRF-produzierendem mediastinalem Karzinoid
| Autor: | H. Gerl, H. Martin, G. Knappe, F. Stahl, W. Rohde, H. Wolff |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
endocrine system
medicine.medical_specialty S syndrome business.industry Autopsy General Medicine Venous blood Hyperplasia medicine.disease Gastroenterology Sepsis Lesion Internal medicine medicine Carcinoid tumour medicine.symptom Myopathy business hormones hormone substitutes and hormone antagonists |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 115:332-336 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2008-1065011 |
| Popis: | A 36-year-old patient developed marked pigmentation, marked myopathy and severe hypokalaemic alkalosis which at first pointed towards an ectopic ACTH syndrome. The dexamethasone test at a high dose indicated cortisol suppression. A mediastinal tumour was seen radiologically, but the sella was of normal size. Computed tomography provided indirect signs of a sellar space-occupying lesion which suggested an ectopic production of corticotropin-releasing factor (CRF) as cause of the Cushing's syndrome. CRF concentration in antecubital venous blood was markedly elevated to 280 ng/l. The mediastinal tumour was excised and proved to be a carcinoid histologically. Postoperatively the CRF concentration fell to 70 ng/l. An extract of the carcinoid contained 15.5 ng/g wet-weight of CRF and 254 ng/g wet-weight of beta-endorphin. The patient died 5 weeks postoperatively of sepsis with bilateral pneumonia. At autopsy the hypophysis was of normal size but showed nodular ACTH-cell hyperplasia. This was thus a case of Cushing's syndrome resulting from ectopic CRF production in a mediastinal carcinoid tumour. |
| Databáze: | OpenAIRE |
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