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[A rare form of adrenal Cushing's syndrome]

Gábor Sohár1, Nikolette Szücs, Károly Rácz

  • 1Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Zala Megyei Kórház Belgyógyászati Osztály Zalaegerszeg Zrínyi Miklós út 1. 8900.

Orvosi Hetilap
|December 10, 2013
PubMed

Insights

This case study highlights a rare instance of aortic coarctation and Cushing's syndrome in an elderly male. Treatment with ketoconazole and subsequent surgery improved his condition.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • A 74-year-old male presented with severe hypokalemia, prompting an endocrine evaluation.
  • Diagnostic workup revealed Cushing's syndrome secondary to bilateral macronodular adrenal hyperplasia.

Purpose of the Study:

  • To report a unique case of coexisting aortic coarctation and Cushing's syndrome.
  • To discuss the management challenges and outcomes in an elderly patient.

Main Methods:

  • Endocrine evaluation for hypokalemia.
  • Diagnosis of Cushing's syndrome via bilateral macronodular adrenal hyperplasia.
  • Pharmacological treatment with ketoconazole (steroid biosynthesis inhibitor).
  • Interventional treatment for aortic coarctation.

Main Results:

  • Ketoconazole led to clinical and biochemical regression of hypercortisolism.
  • Surgical intervention for aortic coarctation resulted in significant physical and cardiac improvement.
  • The patient tolerated surgery well despite advanced age.

Conclusions:

  • The coexistence of aortic coarctation and bilateral macronodular adrenal hyperplasia is rare and previously unreported.
  • Management requires a multidisciplinary approach, addressing both endocrine and cardiovascular aspects.
  • Surgical intervention for aortic coarctation can be beneficial even in elderly patients.

Keywords:
Cushing-szindrómaCushing’s syndromeaortic coarctationbilateral macronodular adrenal hyperplasiabilateralis macronodularis mellékvesekéreg-hyperplasiacoarctatio aortae

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