title: A juvenile case of Cushing's disease incidentally discovered with multiple bone fractures.
abstract: 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.
authors.affiliation: 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>
authors.forename: Ai
authors.initials: A
authors.lastname: Yoshihara
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Okubo
authors.forename: Akiyo
authors.initials: A
authors.lastname: Tanabe
authors.forename: Akira
authors.initials: A
authors.lastname: Sata
authors.forename: Momoko
authors.initials: M
authors.lastname: Nishimaki
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
authors.forename: Osami
authors.initials: O
authors.lastname: Kubo
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Hori
authors.forename: Kazue
authors.initials: K
authors.lastname: Takano
mesh_terms: 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*
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone