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A Case-Based Guide to Clinical EndocrinologyAbrupt Weight Gain, Hypertension, and Severe Hypokalemia in a Young Male

A Case-Based Guide to Clinical Endocrinology: Abrupt Weight Gain, Hypertension, and Severe... [Cushing’s syndrome (CS) can be difficult to differentiate from metabolic syndrome and obesity, and increased awareness is needed. More specific signs of disease result from the underlying catabolic state of hypercortisolism. When adrenocorticotropic hormone (ACTH)-dependent CS is confirmed, a next step is localization of ACTH excess, which is achieved with pituitary imaging and inferior petrosal sinus sampling. For patients who have ectopic CS, chest and abdomen computed tomography/magnetic resonance imaging and functional imaging can be undertaken. However, in a few cases, a tumor is not discovered. If a patient is experiencing rapid clinical deterioration, treatment with medical therapy and/or bilateral adrenalectomy should be prioritized over etiologic or localization workup. Risk of complications, including infections and cardiovascular and deep vein thrombosis, should be acknowledged. Complication prevention and management should be instituted promptly in all CS patients, particularly for those who have severe CS and hence a higher mortality risk.] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyAbrupt Weight Gain, Hypertension, and Severe Hypokalemia in a Young Male

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Publisher
Springer International Publishing
Copyright
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022
ISBN
978-3-030-84366-3
Pages
27 –41
DOI
10.1007/978-3-030-84367-0_3
Publisher site
See Chapter on Publisher Site

Abstract

[Cushing’s syndrome (CS) can be difficult to differentiate from metabolic syndrome and obesity, and increased awareness is needed. More specific signs of disease result from the underlying catabolic state of hypercortisolism. When adrenocorticotropic hormone (ACTH)-dependent CS is confirmed, a next step is localization of ACTH excess, which is achieved with pituitary imaging and inferior petrosal sinus sampling. For patients who have ectopic CS, chest and abdomen computed tomography/magnetic resonance imaging and functional imaging can be undertaken. However, in a few cases, a tumor is not discovered. If a patient is experiencing rapid clinical deterioration, treatment with medical therapy and/or bilateral adrenalectomy should be prioritized over etiologic or localization workup. Risk of complications, including infections and cardiovascular and deep vein thrombosis, should be acknowledged. Complication prevention and management should be instituted promptly in all CS patients, particularly for those who have severe CS and hence a higher mortality risk.]

Published: Jan 4, 2022

Keywords: Cushing’s syndrome; ACTH-dependent Cushing’s; Ectopic Cushing’s; Bilateral adrenalectomy; PJP pneumonia; DVT prophylaxis

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