title: Preclinical Cushing's syndrome presenting with isolated adrenocorticotropin (ACTH) deficiency-like manifestations and severe hypoalbuminemia without overt adrenal masses in a patient with Chilaiditi syndrome and mental retardation.
abstract: A 52-year-old man with Chilaiditi syndrome and mental retardation was admitted to Kanagawa Rehabilitation Hospital for severe hypoglycemic coma with malnutrition. This patient was first diagnosed as partial isolated adrenocorticotropin deficiency according to his symptoms and clinical course, but he was finally diagnosed as preclinical Cushing's syndrome. Manifestations of this case seemed unusual in spite of autonomic cortisol secretion and the detailed mechanisms of symptoms were unclear. The present case indicates that preclinical Cushing's syndrome may present with various manifestations, and careful diagnosis is necessary.
authors.affiliation: Department of Internal Medicine, Kanagawa Rehabilitation Hospital, Atsugi.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ikeda
authors.forename: Masato
authors.initials: M
authors.lastname: Mizuguchi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ebisawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uchida
authors.forename: Hideaki
authors.initials: H
authors.lastname: Okabe
authors.forename: Toru
authors.initials: T
authors.lastname: Sekita
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tojo
authors.forename: Naoko
authors.initials: N
authors.lastname: Tajima
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya
mesh_terms: D000310:Adrenal Gland Neoplasms; D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D000740:Anemia / Q000150:complications; D003480:Cushing Syndrome / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000150:complications*; D007003:Hypoglycemia / Q000150:complications; D008607:Intellectual Disability / Q000150:complications*; D007410:Intestinal Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications
chemical_list: D000324:Adrenocorticotropic Hormone