title: [Difficulties in the diagnosis of ACTH-dependent Cushing's syndrome in a patient after left adrenalectomy and treated with glucocorticoids].
abstract: Cushing's syndrome (CS), that is a consequence of chronic excess of corticosteroides, is most frequently of iatrogenic origin. Corticotropin secreting pituitary adenomas are responsible for most cases of endogenous Cushing' s syndrome. Difficulties in the diagnosis and treatment of ACTH-dependent Cushing's syndrome concern with localization of the source of pathological ACTH secretion, particularly when magnetic resonance imaging is unable to identify the pituitary microadenoma. In this paper we present the case of a patient with symptoms of Cushing's syndrome and describe problems with localization of the source of hypercortisolemia. The diagnostic process was additionally complicated by the treatment with corticosteroids, occasionally applied due to concomitant diseases. This delayed the right diagnosis and treatment.
authors.affiliation: Klinika Endokrynologii i Diabetologii z Pracowniq Medycyny Nuklearnej Collegium Medicum, Bydgoszcz. piootr5@wp.pl
authors.forename: Barbara
authors.initials: B
authors.lastname: Brzezińska
authors.forename: Roman
authors.initials: R
authors.lastname: Junik
authors.forename: Anna
authors.initials: A
authors.lastname: Kamińska
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zieliński
mesh_terms: D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000328:Adult; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D057210:Delayed Diagnosis; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery
chemical_list: D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D011241:Prednisone; D008775:Methylprednisolone