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Subclinical Cushing's disease accompanied by malignant hypertension and diabetes mellitus

Takashi Nagai1, Makoto Imamura, Shuuzou Misumi

  • 1Department of Internal Medicine, Public Tomioka General Hospital, Gunma.

Internal Medicine (Tokyo, Japan)
|July 23, 2002
PubMed

Insights

Subclinical Cushing's disease, a pituitary adenoma, can cause severe hypertension and diabetes. Early diagnosis and surgical removal of the ACTH-secreting tumor led to significant patient improvement.

Area of Science:

  • Endocrinology
  • Oncology
  • Nephrology

Background:

  • Malignant hypertension and diabetes mellitus can present with complex etiologies.
  • Subclinical endocrine disorders may manifest with severe systemic complications.

Observation:

  • A 53-year-old woman presented with malignant hypertension and uncontrolled diabetes mellitus.
  • Elevated adrenocorticotropic hormone (ACTH) and cortisol levels were noted, unresponsive to dexamethasone suppression.
  • A pituitary tumor was identified via MRI, later confirmed as an ACTH-secreting adenoma.

Findings:

  • Surgical resection of the pituitary adenoma resulted in normalization of blood pressure, renal function, glucose levels, and hormone profiles.
  • Histopathological examination confirmed the ACTH-secreting pituitary adenoma (Cushing's disease).

Implications:

  • This case highlights that subclinical Cushing's disease can manifest as severe secondary hypertension and diabetes.
  • Prompt diagnosis and treatment of pituitary adenomas are crucial for managing associated systemic comorbidities.
  • Highlights the importance of considering endocrine causes in patients with resistant hypertension and metabolic derangements.

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