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Acute pancreatitis associated with Cushing syndrome - A case report and literature review
M Bouali1,2, S Kabura2,3, A El Bakouri1,2
1Service of Emergency of Visceral Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco.
Insights
Cushing syndrome (CS) is rarely associated with acute pancreatitis. This case highlights CS as a potential risk factor for acute pancreatitis, emphasizing the need for further research into this uncommon but severe condition.
Area of Science:
- Endocrinology
- Gastroenterology
Background:
- Cushing syndrome (CS) is a rare and severe endocrine disorder.
- Acute pancreatitis is a significant cause of hospitalizations.
- The co-occurrence of CS and acute pancreatitis is exceptionally uncommon.
Observation:
- A 37-year-old woman presented with epigastric pain and vomiting.
- She had a history of corticosteroid use and exhibited symptoms of CS.
- Diagnostic imaging confirmed acute edematous-interstitial pancreatitis.
Findings:
- Elevated 24-hour urinary free cortisol and serum cortisol levels were detected.
- The patient was diagnosed with Cushing syndrome during hospitalization for acute pancreatitis.
- CS is suggested as a potential risk factor for acute pancreatitis onset.
Implications:
- This case underscores the rare association between Cushing syndrome and acute pancreatitis.
- Further investigation is warranted to establish a definitive causative relationship.
- Standard management protocols for acute pancreatitis apply to patients with CS.
Introduction:
Cushing's syndrome (CS) is a rare and severe disease. Acute pancreatitis is the leading cause of hospitalization. The association of the two disease is rare and uncommon. We report the case of a 37-year-old woman admitted in our service for acute pancreatitis and whose Cushing syndrome was diagnosed during hospiatilisation. The aim of this work is to try to understand the influence of de Cushing in acute pancreatitis and to establish a causative relationship between the two diseases.
Observation:
It is a 37-year-old woman with a history of corticosteroid intake for six months, stopped three months ago who consulted for epigastralgia and vomiting. The physical exam found epigastric sensitivity with Cushing syndrome symptoms. A CT scan revealed acute edematous-interstitial pancreatitis stage E of Balthazar classification. 24 h free cortisol of 95 μg/24 h and cortisolemia of 3.4 μg/dl. The patient was treated symptomatically and referred after to endocrinology service for further treatment.
Conclusion:
The association with acute pancreatitis and CS is rare and uncommon. Although detailed studies and evidence are lacking, it can therefore be inferred that CS is one of the risk factors for the onset of acute pancreatitis. The medical treatment and management of acute pancreatitis in those patients do not differ from other pancreatitis of any etiologies.
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