Osteoporosis: ¿Diagnóstico o signo de sospecha?
| Autor: | Lorente, M.D. (María Dolores), Marginet, C. (C.), Pujante, P. (P.) |
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| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Dadun. Depósito Académico Digital de la Universidad de Navarra instname |
| ISSN: | 2444-2836 |
| DOI: | 10.15581/021.7695 |
| Popis: | Objetivo: Se presenta un caso clínico de un paciente varón de 52 años que acude a consulta de Neurología por referir en los últimos meses deterioro progresivo del estado general con deterioro cognitivo, espe- cialmente de memoria y funciones ejecutivas, debilidad proximal en las cuatro extremidades, dolor en zona lumbar y disminución de 10 cm de talla. Se realizó una densitometría ósea siendo diagnosticado de osteoporosis precoz. Resultados/conclusión: En la analítica se objetivó aumento del cortisol libre en orina (1725 g/24h), con ACTH detectable (89 pg/ml) compati- ble con síndrome de Cushing ACTH-dependiente. Se realizaron pruebas para diferenciar un posible origen hipofi sario o ectópico realizándose un cateterismo de senos petrosos (CSPI) dado que se trata de la prueba con mayor sensibilidad demostrada. INGLÉS: We present the case of a fifty-year-old male who presented at the Neurology Service. During the previous months he had noticed progressive cognitive deterioration, and particularly a loss of memory and executive abilities, as well as proximal weakness of the four limbs and lumbar tenderness. He had lost ten centimetres of height. A bone densitometry was performed, which showed early osteoporosis. RESULTS/CONCLUSIONS: The laboratory results showed an increase in urine cortisol excretion (1725 g/24h), with detectable plasma ACTH concentration (89 pg/ml), suggesting ACTH-dependent Cushing's syndrome, Additional tests were run in order to determine a hypothalamic or ectopic location of the syndrome. To this end, a bilateral inferior petrosal sinus sample (BIPSS) was performed for ACTH determination. BIPSS is the test that has been proven to have the best sensitivity to achieve differential diagnosis of ACTH-dependent Cushing's syndrome |
| Databáze: | OpenAIRE |
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