[Ectopic ACTH syndrome and severe hypokalaemia].
Cushing's syndrome is rare and remains a challenge to diagnose. Particularly difficult are the differentiation between Cushing's syndrome and Pseudo-Cushing's states and between the two forms of ACTH dependent Cushing's: Cushing's disease and ectopic ACTH syndrome. We report the case of a patient diagnosed with a metastatic small cells lung carcinoma associated with ectopic ACTH-syndrome. Hypokalaemia was a clue to diagnosis. We focus on critical questions addressing diagnosis and differential diagnosis of Cushing's syndrome and we explain the mechanism of hypokalaemia.
Servonnet
A
A
Fédération de biologie clinique, Hôpital d'Instruction des Armées Robert Picqué, Bordeaux. a_servonnet@yahoo.fr
Delacour
H
H
Roux
X
X
Dehan
C
C
Gardet
V
V
Morand
C
C
D000182:ACTH Syndrome, Ectopic / Q000097:blood* / Q000209:etiology; D000328:Adult; D001774:Blood Chemical Analysis; D018288:Carcinoma, Small Cell / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D003480:Cushing Syndrome / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000097:blood* / Q000209:etiology; D007958:Leukocyte Count; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D009362:Neoplasm Metastasis