Bromocriptine-responsive Cushing's disease; clinical and biochemical remission accompanied by amelioration of impaired ocular movement.
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.
Kawamura
Mitsunobu
M
Division of Endocrinology and Metabolism, Department of Internal Medicine, Tokyo Teishin Hospital. mkawamura@tth-japanpost.jp
Nakano
Tae
T
Miki
Hiroko
H
Tamura
Yuriko
Y
Miyazaki
Shigeru
S
Hirata
Yukio
Y
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
D006727:Hormone Antagonists; D001971:Bromocriptine