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Related Concept Videos

Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Peptic Ulcer Disease II: Pathophysiology01:24

Peptic Ulcer Disease II: Pathophysiology

Peptic ulcer disease develops when protective mechanisms of the gastrointestinal mucosa are overwhelmed by harmful factors, leading to localized erosions in the stomach or proximal duodenum. The main causes are Helicobacter pylori infection and chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs).Helicobacter pylori–Induced InjuryBacterial Adaptation and Colonization:H. pylori is a spiral, Gram-negative bacterium adapted to the acidic stomach. and transmitted through oral-oral or...
Peptic Ulcer Disease II: Pathophysiology01:28

Peptic Ulcer Disease II: Pathophysiology

Peptic Ulcer Disease (PUD) is characterized by the development of ulcers in the stomach or duodenal mucosa. Its pathophysiology is complex, involving a balance between damaging and protective elements.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
Peptic Ulcer Disease III: Clinical Manifestations and Complications01:25

Peptic Ulcer Disease III: Clinical Manifestations and Complications

Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...
Peptic Ulcer01:27

Peptic Ulcer

Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...

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Another 'Cushing ulcer'.

Chisho Hoshino1, Noriyuki Satoh, Masashi Narita

  • 1Department of General Internal Medicine, Ohta-Nishinouchi Hospital, Koriyama, Japan. gim-hoshino@ohta-hp.or.jp

BMJ Case Reports
|June 16, 2012
PubMed
Summary
This summary is machine-generated.

A 39-year-old man with fatigue and hypertension was diagnosed with Cushing's disease due to a pituitary adenoma. This case highlights the importance of considering endocrine disorders in patients with peptic ulcer disease.

Related Experiment Videos

Area of Science:

  • Endocrinology
  • Gastroenterology
  • Neurology

Background:

  • Cushing's disease, a condition caused by excess cortisol, can present with nonspecific symptoms like fatigue.
  • Peptic ulcer disease and Helicobacter pylori infection are common gastrointestinal issues.
  • Hypertension and electrolyte imbalances are frequently observed in endocrine disorders.

Observation:

  • A 39-year-old male presented with easy fatigability, malaise, hypertension, anemia, hyperglycemia, and hypokalemia.
  • Upper endoscopy revealed an active gastric ulcer with Helicobacter pylori infection.
  • Endocrine testing showed elevated adrenocorticotropic hormone and cortisol with loss of diurnal variation.

Findings:

  • Brain MRI and inferior petrosal sinus sampling confirmed a pituitary adenoma as the cause of Cushing's disease.
  • The patient's symptoms were attributed to the combined effects of Cushing's disease and peptic ulcer disease.

Implications:

  • This case underscores the necessity for physicians to investigate potential endocrine backgrounds in patients presenting with peptic ulcer disease.
  • Early recognition of Cushing's disease is crucial for timely diagnosis and management, preventing complications.
  • Integrating gastrointestinal and endocrine evaluations can improve patient outcomes.