title: Bromocriptine-responsive Cushing's disease; clinical and biochemical remission accompanied by amelioration of impaired ocular movement.
abstract: A 73-year-old woman presented with disturbance of right eyelid opening with ptosis and impairment of right ocular movement, and later was found to have Cushingoid features. Endocrine examinations revealed that plasma ACTH and cortisol levels were elevated, lack of circadian rhythm, resistant to low-doses (0.5, 1, 2 mg) and high-dose (8 mg) dexamethasone, and responsive to CRH and DDAVP. Magnetic resonance imaging (MRI) revealed a large pituitary tumor invading the right cavernous sinus. After two months treated with bromocriptine (5 mg/day), she showed clinical improvement with normalization of plasma ACTH and cortisol levels, and improvement of right eyelid opening and ocular movement. MRI, however, revealed no apparent reduction in the size of pituitary tumor. This is a rare case of bromocriptine-responsive Cushing's disease.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Tokyo Teishin Hospital. mkawamura@tth-japanpost.jp
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Kawamura
authors.forename: Tae
authors.initials: T
authors.lastname: Nakano
authors.forename: Hiroko
authors.initials: H
authors.lastname: Miki
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Tamura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirata
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D001971:Bromocriptine / Q000627:therapeutic use*; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D015835:Ocular Motility Disorders / Q000188:drug therapy / Q000209:etiology; D047748:Pituitary ACTH Hypersecretion / Q000188:drug therapy* / Q000209:etiology; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D006727:Hormone Antagonists; D001971:Bromocriptine