Diagnostic Difficulties in a Young Women With Symptoms of Cushing Syndrome

Szczepanek‐Parulska, Ewelina; Cyrańska-Chyrek, Ewa; Nowaczyk, Marta; Kamiński, Grzegorz; Zieliński, Grzegorz; Kuśmierek, Anna; Mazurek, Andrzej; Styk, Andrzej; Zięcina, Piotr; Ruchała, Marek

doi:10.4158/ep-2017-0257

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…The serum cortisol level at diagnosis in the present case was higher than in the previous case reports. We have summarized case reports and reviewed patients with ACTH‐producing thymic tumors over the past 10 years published in English, and the cortisol and ACTH levels are presented in Table . Serum cortisol and plasma ACTH levels in our patient were relatively high, and we speculated that the extremely high cortisol level could have been related to the development of severe psychosis.…”

Section: Discussionmentioning

confidence: 99%

ACTH‐producing thymic neuroendocrine tumor initially presenting as psychosis: A case report and literature review

et al. 2019

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A 32‐year‐old woman was referred to our hospital because of severe psychosis and was found to have an ectopic ACTH‐producing thymic neuroendocrine tumor. Laboratory data revealed an elevated serum cortisol and plasma ACTH level, hypokalemia, and metabolic alkalosis. Chest computed tomography (CT) revealed an anterior mediastinal mass and multiple pulmonary nodules. As the patient was unable to communicate because of her consciousness disturbance, she was managed with artificial ventilation and deep sedation. Metyrapone and potassium supplementation were administered, and steroid psychosis gradually improved. Thoracic surgery was performed and the histopathological diagnosis was thymic neuroendocrine tumor with positive anti‐ACTH immunohistochemical staining. Here we present details of the case and review the literature.

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Section: Discussionmentioning

confidence: 99%

ACTH‐producing thymic neuroendocrine tumor initially presenting as psychosis: A case report and literature review

et al. 2019

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“…The scale of changes observed in the lipid profile depends on the magnitude of hypercortisolaemia [64]. Typical clinical features of Cushing's syndrome include central obesity with characteristic moon facies, buffalo hump, thick, purple striae, and easy bruising [65,66]. An increased amount of adipose tissue, especially visceral fat, increases the risk of metabolic syndrome occurrence.…”

Section: Cushing's Syndromementioning

confidence: 99%

Lipid profile abnormalities associated with endocrine disorders

et al. 2022

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low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). However, we also shed light on the influence of endocrine disorders on relatively new cardiovascular markers, such as apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), and lipoprotein(a) [Lp(a)]. Apo B is the primary apolipoprotein of atherogenic lipoproteins, including very low-density lipoprotein (VLDL), Lp(a), intermediate-density lipoprotein (IDL), and low-density lipoprotein (LDL). Apo B has 2 major isoforms: Apolipoprotein B-48 (Apo B48), mainly expressed in the intestine, and Apolipoprotein B100 (Apo B-100), which is expressed in the liver [3,4]. Apo B can be used as a marker of cardiovascular risk, and according to recent data, it is a more reliable indicator of the risk than LDL-C [5]. Apo A1 is the main component in high-density lipoprotein [6], and it is considered to be a factor inversely corelated with the risk of atherosclerosis and cardiovascular disease [7]. Lp(a) is a lipoprotein particle produced in the liver, which constitutes an independent risk factor for cardiovascular disease [8].

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“…ACTH (adrenocorticotropic hormone)-secreting pituitary adenomas are the most common underlying condition of endogenous hypercortisolaemia [46,47].…”

Section: Cushing's Diseasementioning

confidence: 99%

Changes in complete blood count parameters influenced by endocrine disorders

Szczepanek‐Parulska

Adamska

Korda

et al. 2021

Endokrynologia Polska

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Complete blood count is one of the most common diagnostic methods used in everyday practice. Hormonal status is known to affect blood count parameters. The aim of this study is to summarize changes in blood count that may indicate endocrine disorders, based on a literature review. Red cell parameters deteriorate in thyroid disorders including autoimmune thyroiditis and tend to resolve with appropriate treatment implementation. The most frequent form of anaemia associated with thyroid dysfunction is normocytic anaemia. Macrocytic anaemia is more typical of autoimmune thyroiditis-induced hypothyroidism, while microcytic anaemia is more common in hyperthyroidism. Unexplained anaemia or an increase in red cell distribution width should prompt the investigation of thyroid disorders. Cushing's disease may manifest as an increase in white blood cells and platelets. In the blood smear, neutrophilia is often present, while lymphocytes and eosinophils may be within the lower normal range. Hypercortisolism may induce both hyperaemia and anaemia. In hypopituitarism, a decrease in red blood cell count, haemoglobin, haematocrit, and platelets is observed. Acromegaly may be accompanied by an increase in mean corpuscular volume of erythrocytes. Testosterone deficiency is manifested by a decrease in red cell parameters, whereas hyperandrogenism may lead to polycythaemia. In polycystic ovary syndrome an increase in white blood cell count reflects an underlying inflammatory state. Complete blood count analysis is an easily available and cost-effective additional tool in the diagnosis and treatment monitoring of endocrine disorders.

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Diagnostic Difficulties in a Young Women With Symptoms of Cushing Syndrome

Cited by 5 publications

References 2 publications

ACTH‐producing thymic neuroendocrine tumor initially presenting as psychosis: A case report and literature review

ACTH‐producing thymic neuroendocrine tumor initially presenting as psychosis: A case report and literature review

Lipid profile abnormalities associated with endocrine disorders

Changes in complete blood count parameters influenced by endocrine disorders

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