A Case of Cushing's Disease with Renal Cell Carcinoma and End-stage Renal Disease
| Autor: | Lee Jang Eun, Yu Bai Ahn, Seung Hyun Ko, Ik Jun Choi, Kyoung-Hwan Lee, Hyo-Jin Lee, Ki Ho Song, Young Jai Park |
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| Rok vydání: | 2007 |
| Předmět: |
endocrine system
medicine.medical_specialty education.field_of_study business.industry medicine.medical_treatment Urinary system Population Adrenocorticotropic hormone Cushing's disease medicine.disease Gastroenterology End stage renal disease Endocrinology Renal cell carcinoma Internal medicine medicine education business hormones hormone substitutes and hormone antagonists Dialysis Dexamethasone medicine.drug |
| Zdroj: | Journal of Korean Endocrine Society. 22:62 |
| ISSN: | 1015-6380 |
| Popis: | Cushing's disease is the most common cause of endogenous Cushing's syndrome caused by the excessive secretion of adrenocorticotropic hormone (ACTH) by pituitary ACTH-secreting tumors. The tumors are usually microadenomas (< 10 mm in diameter). Macroadenomas are rare, and corticotroph hyperplasia and carcinomas are extremely rare. Patients with these tumors exhibit an increase in plasma ACTH and cortisol levels, elevated urinary excretion of cortisol and adrenocortical steroid metabolites, evidence of altered negative feedback of cortisol and disturbances in neuroendocrine regulation. The diagnosis of Cushing's disease can be challenging in patients with renal failure the presence of abnormal plasma cortisol, poor gastrointestinal tract absorption of dexamethasone and altered functioning of the hypophyseal-pituitary-adrenal axis have been reported in end-stage renal disease, and the urinary cortisol increment method is not reliable in these patients. The prevalence of renal cell carcinoma in patients on dialysis is higher than in the general population. We recently treated a patient with Cushing's disease and end-stage renal disease as a result of renal cell carcinoma. The diagnosis was made by laboratory evaluation of plasma and radiological examination. Here we report a case of Cushing's disease with a review of the medical literature. (J Kor Endocrinol Soc 22:62~67, 2007) |
| Databáze: | OpenAIRE |
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