| Autor: |
Mauro A, Czepielewski, Maikel, Colli, Tatiana, Harlos, Sandra Pinho, Silveiro, Jorge, Maraschin, Fabio, Copette, Cristiane B, Leitão, Guilherme A F S, Rollin |
| Rok vydání: |
2006 |
| Předmět: |
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| Zdroj: |
Arquivos brasileiros de endocrinologia e metabologia. 49(5) |
| ISSN: |
0004-2730 |
| Popis: |
Cushing's syndrome (CS) due to ectopic ACTH secretion has a high morbidity and mortality. Thus, rapid treatment of ectopic CS is mandatory. Carcinoid tumors associated with ectopic ACTH (CTu-ACTH) syndrome represent a more severe clinical picture, due to the carcinoid symptoms that worsen the hypercortisolism state. Management of patients with CTu-ACTH should include the control of hypercortisolism, as well as the carcinoid disturbance. We report 3 patients (2F, 1M) with CTu-ACTH (2 pancreatic, 1 occult) who presented with clinical manifestations of CS (n= 3) and carcinoid syndrome (2): 2 were initially investigated for CS and 1 carcinoid syndrome. In all hypokalemia, hypertension and diabetes mellitus were associated with severe hypercortisolism and high ACTH levels. Administration of octreotide-LAR reduced ACTH levels from 230,000 to 30,000 pg/ml in patient 1, and controlled symptoms of carcinoid syndrome and neoplasic lesions in patient 2; treatment with subcutaneous octreotide in patient 3 controlled carcinoid syndrome and partially reduced symptoms of hypercortisolism. All 3 patients were submitted to bilateral adrenalectomy to control CS. Our data show that combined anti-neoplastic therapy may contribute to the stabilization and/or definitive control of CTu-ACTH. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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