A juvenile case of Cushing's disease incidentally discovered with multiple bone fractures.
A 19-year-old woman who had decreased eight centimeters in stature was diagnosed as Cushing's disease with multiple spine compression fractures. At the age of 18, the patient had a complex fracture and gradually presented the features of Cushing's syndrome. Her plasma ACTH and cortisol levels were extremely high. Radiological findings and chemical markers for bone metabolism showed severe osteoporosis. Magnetic resonance imaging showed the presence of a pituitary microadenoma. After transsphenoidal surgery was performed, subsequently all endocrine data improved. This case indicates that Cushing's syndrome should be considered for severe osteoporotic juvenile patients.
Yoshihara
Ai
A
The Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University, Tokyo, Japan. ayoshihara@endm.twmu.ac.jp <ayoshihara@endm.twmu.ac.jp>
Okubo
Yumiko
Y
Tanabe
Akiyo
A
Sata
Akira
A
Nishimaki
Momoko
M
Kawamata
Takakazu
T
Kubo
Osami
O
Hori
Tomokatsu
T
Takano
Kazue
K
D015502:Absorptiometry, Photon; D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D003480:Cushing Syndrome / Q000150:complications / Q000175:diagnosis; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D033162:Incidental Findings; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology; D047748:Pituitary ACTH Hypersecretion / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone