A 'smart' type of Cushing's syndrome
| Autor: | J.W.F. Elte, M. Castro Cabezas, H.C.T. van Zaanen, A.P. Rietveld, A J Razenberg |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Pituitary gland medicine.medical_specialty Hydrocortisone Narcotic Substance-Related Disorders Endocrinology Diabetes and Metabolism medicine.medical_treatment Cushing syndrome Endocrinology Internal medicine medicine Humans Receptor Cushing Syndrome business.industry General Medicine medicine.disease medicine.anatomical_structure Blood pressure Dexamethasone suppression test Hypertension Abdomen Female business Sodium Oxybate Narcolepsy |
| Zdroj: | European journal of endocrinology. 157(6) |
| ISSN: | 1479-683X |
| Popis: | Cushing's syndrome results from lengthy and inappropriate exposure to excessive concentrations of either endogenous or exogenous glucocorticoids. This case report describes a patient with a novel type of Cushing's syndrome due to the use of party drugs. A 35-year-old woman had gained 8 kg body weight in 5 months and complained of anxiety. She showed a Cushing-like appearance and mild hypertension (blood pressure, BP 150/95 mmHg). She reported daily use of increasing doses of gamma-hydroxybutyric acid (GHB), a popular party drug. ACTH plasma levels were in the upper normal range (41 ng/l), with normal plasma cortisol (0.36 micromol/l). She showed an abnormal overnight 1 mg dexamethasone suppression test (cortisol 0.38 micromol/l). The urinary excretion of free cortisol in 24 h was also increased (0.47 micromol/24 h). CT scanning of the abdomen showed normal adrenals. After stopping GHB intake she lost 7 kg body weight and her BP normalized (BP 135/80 mmHg). GHB is a popular party drug in the Netherlands, but it is also used as a narcotic and for the treatment of narcolepsy. We hypothesize that GHB may bind to the pituitary gland gamma-aminobutyric acid-B receptors leading to ACTH overproduction. |
| Databáze: | OpenAIRE |
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