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Related Experiment Video

Updated: Mar 2, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Cushing's Syndrome, Cortisol, and Cognitive Competency: A Case Report.

Neil Oronsky1, Bennett Thilagar2, Carolyn M Ray3

  • 1aCFLS, San Jose, CA, USA.

Case Reports in Oncology
|May 18, 2017
PubMed
Summary
This summary is machine-generated.

Cushing's syndrome (CS) patients with neurocognitive issues require advanced care planning. Early discussions are crucial for managing complex medical decisions, especially when sepsis develops.

Keywords:
ACTHAdvanced directivesCarcinoid patientCushing's syndromeGlucocorticoidsImmunosuppressionNeurocognitive impairment

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Area of Science:

  • Endocrinology
  • Oncology
  • Neuroscience

Background:

  • Glucocorticoids, like those involved in Cushing's syndrome (CS), are known to cause immunosuppression and neuropsychiatric issues.
  • Ectopic ACTH production can lead to severe CS, characterized by excessive cortisol levels.
  • Neurocognitive impairment is a recognized complication in patients with CS.

Observation:

  • A carcinoid patient presented with CS and neurocognitive deficits secondary to ectopic ACTH production.
  • The patient developed sepsis, a life-threatening condition.
  • The family opted to withdraw antibiotic treatment, leading to the patient's death.

Findings:

  • This case highlights the complex interplay between CS, neurocognitive impairment, and critical illness.
  • The decision to withdraw treatment underscores the challenges in managing end-of-life care for patients with complex endocrine and neurological conditions.

Implications:

  • Advanced-care planning is essential for patients with CS, particularly those with neurocognitive complications.
  • Proactive discussions about treatment preferences and end-of-life care can guide medical teams and families during critical situations.
  • This case emphasizes the need for integrated care approaches in managing carcinoid syndrome and its associated complications.