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031 Journal of Nara Medical Association >
Vol.49 No.1 >
Please use this identifier to cite or link to this item:
http://hdl.handle.net/10564/426
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| Title: | A CASE OF OCCULT ECTOPIC CORTICOTROPIN (ACTH) SYNDROME MAITAINING REMISSION STATE OVER 4 YEARS AFTER BILATERAL ADRENALECTOMY |
| Authors: | Shingo Okamoto
Yohichi Hokaze
Makoto Matsumoto
Yukiko Izumi
Akiko Hosokawa
Munehisa Saka
Katsunori Yoshida
Yoshihiko Hirao
Shigeki Kuriyama
Hiroshi Fukui |
| Keywords: | Ectopic corticotropin syndrome
ectopic ACTH syndrome
Cushing's syndrome
bilateral adrenalectomy |
| Issue Date: | 28-Feb-1998 |
| Publisher: | 奈良医学会 |
| Citation: | 奈良医学雑誌 Vol.49 No.1 p.74-83 |
| Abstract: | A long-lasting state of remission of over 4 years of occult ectopic cor-
ticotropin (ACTH) syndrome in a 68-year-old female is reported. She presented with
general malaise, muscle atrophy and weakness of extremities, general petechiae and
hypokalemia. Although ectopic ACTH syndrome was suspected due to marked hypercor-
tisolism and ACTH elevation, the source of ACTH secretion could not detected by any
diagnostic technique. Because of that effective suppression of plasma cortisol levels by
torilostane, a 3 β-hydroxy-steroid-dehydrogenase inhibitor, could not obtained, so bilateral
adrenalectomy was performed. After the operation, supplemental therapy of hydrocor-
tisone and Florinef, 9 α-fluorohydrocortisone, was initiated and the plasma ACTH levels
decreased gradually. At the 6th postoperative month, the levels of ACTH remained within
the normal range and her general status markedly improved. At the 4th postoperative year,
the plasma ACTH still maintained normal levels with no recurrence. Cases of occult
ectopic ACTH syndrome which remain in remission for a long period after bilateral
adrenalectomy are rare and interesting. Bilateral adrenalectomy may be the first choice of
treatment for occult ectopic ACTH syndrome with the support of chemical therapy. |
| URI: | http://hdl.handle.net/10564/426 |
| ISSN: | 04695550
13450069 |
| Appears in Collections: | Vol.49 No.1
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| 74-83p.A CASE OF OCCULT ECTOPIC CORTICOTROPIN.pdf | | 1833Kb | Adobe PDF | View/Open |
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