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Episodic ectopic ACTH syndrome associated with pulmonary infarctions.
1Medical Service, Veterans Administration Hospital, Hines, IL 60141.
Chest
|May 1, 1988
Summary
Ectopic ACTH syndrome, often linked to tumors, was observed in a patient without one. Pulmonary infarctions appeared to stimulate ACTH production, resolving with anticoagulant therapy.
Area of Science:
- Endocrinology
- Pulmonology
- Oncology
Background:
- Ectopic ACTH syndrome (EAS) etiology is often unclear, typically associated with specific tumors.
- Diagnosis of EAS relies on characteristic clinical and laboratory findings.
Observation:
- A patient diagnosed with EAS presented with pulmonary infarctions.
- No evidence of a tumor was found.
- EAS recurred with subsequent pulmonary infarctions.
Findings:
- Treatment with anticoagulants normalized plasma ACTH levels and suppressibility in the patient.
- Pulmonary infarctions resolved during anticoagulant therapy.
- No tumor was detected in five years, with persistent normal ACTH levels.
Implications:
- Pulmonary infarctions may stimulate pulmonary ACTH production, leading to Cushing's syndrome.
- This case suggests a novel mechanism for EAS independent of tumors.
- Further research into non-neoplastic causes of EAS is warranted.