NORMOCORTISOLEMIA AFTER TEN DAYS OCTREOTIDE TREATMENT IN A PATIENT WITH ECTOPIC CUSHING'S SYNDROME DUE TO BRONCHIAL CARCINOID
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Editura Acad Romane
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Contex. We report the use of subcutaneous somatostatin injection three times a day to decrease hypercortisolism in a patient who had Cushing's syndrome induced by bronchial carcinoid tumour progressive pneumonia due to immune suppression. Subject and Method. A 46-year-old man with 7-month history of DM type-2, hypertension and cerebrovascular-disease, vertebral compression-fracture was admitted to our clinic. Physical examination was consistent with Cushing's syndrome. Laboratory results revealed hyperglycemia (143 mg/dL; reference range, <100 mg/dL) and hypokalemia (2.29 mEq/L; reference range, 3.5-5.1 mEq/L). His morning serum cortisol was 40 mu g/dL (reference range 6.7-22.6 mu g/dL), urine cortisol-excretion was 2245 mu g/24 hours (reference range 58-403 mu g/24 hours), after 1 mg dexamethasone-suppression test serum cortisol was 28 mu g/dL (6.7-22.6 mu g/dL) and ACTH 354 pg/mL (reference range 7.9-66 pg/mL). Adrenal CT and hypophyseal MRI were normal. An ectopic source was searched for Cushing's syndrome. Chest CT scan of the right lung showed 12x9 mm nodule. High fever cough occurred on the follow-up. Chest radiograph revealed diffuse pneumonic infiltration. Despite 3-drug antibiotic combination therapy, infection did not improve. Subcutaneous injection of octreotide 3x100 mu g was initiated to decrease hypercortisolism. The infection improved rapidly after the therapy. The morning serum cortisol, urine cortisol-excretion, ACTH was at the upper normal range (77.1 pg/mL, reference range 7.9-66 pg/mL) on 10th day of treatment. The patient was a consulted for surgery and the nodule was excised. The pathology was consistent carcinoid tumor. Conclusion. Subcutaneous octreotide treatment may be helpful to gain time for exploring the focus in ectopic cushing's syndrome and to control the serious infections due to hypercortisolism.
Açıklama
Anahtar Kelimeler
Ectopic Cushing's Syndrome, Octreotide, Carcinoid Tumor
Kaynak
Acta Endocrinologica-Bucharest
WoS Q Değeri
Q4
Scopus Q Değeri
Q4
Cilt
9
Sayı
3
