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Related Experiment Videos

Factitious Cushing's syndrome.

D M Cook, A W Meikle

    The Journal of Clinical Endocrinology and Metabolism
    |August 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    A patient with Cushing's disease showed persistent high cortisol after surgery. Diagnosis of factitious Cushing's syndrome was aided by measuring corticosterone levels, revealing exogenous cortisol intake.

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    Area of Science:

    • Endocrinology
    • Internal Medicine
    • Surgical Oncology

    Background:

    • Pituitary-dependent Cushing's disease requires treatment to manage hypercortisolism.
    • Bilateral adrenalectomy is a surgical option for refractory Cushing's disease.
    • Persistent hypercortisolemia post-adrenalectomy necessitates further investigation.

    Observation:

    • A patient with Cushing's disease remained hypercortisolemic despite bilateral adrenalectomy.
    • Venous catheterization suggested persistent cortisol-secreting tissue in the left adrenal bed.
    • ACTH stimulation showed low corticosterone but high cortisol, indicating exogenous source.

    Findings:

    • The patient's high cortisol levels were determined to be of exogenous origin.
    • Cushingoid features resolved upon confronting the patient with the evidence of factitious disorder.

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  • Plasma corticosterone levels proved crucial in diagnosing factitious Cushing's syndrome.

    • Implications:

    • This case highlights the importance of considering factitious disorders in persistent hypercortisolemia.
    • Plasma corticosterone measurement offers a novel diagnostic approach for factitious Cushing's syndrome.
    • Accurate diagnosis is essential for appropriate management and resolution of symptoms.