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Recurrent Cushing's disease associated with nephrotic syndrome
T Tatsumi1, T Morishima, T Watarai
1Division of Gastroenterology, Osaka Minami National Hospital.
Internal Medicine (Tokyo, Japan)
|January 1, 1995
Summary
Recurrent Cushing's disease with nephrotic syndrome was observed. Pituitary macroadenoma recurrence may be linked to steroid withdrawal for membranoproliferative glomerulonephritis treatment.
Area of Science:
- Endocrinology
- Nephrology
- Neurosurgery
Background:
- Cushing's disease, a condition caused by a pituitary adenoma, can recur after treatment.
- Nephrotic syndrome, characterized by kidney damage, can be associated with various underlying conditions, including glomerulonephritis.
Observation:
- A patient with recurrent Cushing's disease presented with nephrotic syndrome.
- The patient had a history of transsphenoidal surgery for a pituitary adenoma, followed by transcranial surgery and gamma knife therapy due to recurrence.
- Histopathological examination showed advanced membranoproliferative glomerulonephritis (MPGN).
Findings:
- The pituitary adenoma recurred six years after the initial surgery.
- Despite multiple treatments, the patient's pituitary adenoma did not achieve remission.
- The nephrotic syndrome progressed, indicating advanced MPGN.
Implications:
- This case highlights a potential, though possibly coincidental, association between pituitary macroadenoma recurrence and the cessation of steroid treatment for nephrotic syndrome.
- It underscores the complex interplay between endocrine disorders and renal pathology.
- Further research is needed to explore the potential mechanisms linking these conditions.