title: Lethal acute demyelinization with encephalo-myelitis as a complication of cured Cushing's disease.
abstract: Cushing's disease is usually associated with higher mortality rate, especially from cardiovascular causes. Development or exacerbation of autoimmune or inflammatory diseases is known to occur in patients with hypercortisolism after cure. We report for the first time a 34-year old woman with a psychiatric background, who developed four months after the surgical cure of Cushing's disease an acute disseminated encephalomyelitis (ADEM) presenting initially as a psychiatric illness. We hypothesize that the recent correction of hypercortisolism triggered ADEM and that the atypical presentation, responsible for diagnosis delay, led to the death of this patient.
authors.affiliation: Hôpital de l'Archet, CHU de Nice, France. chevalier.n@chu-nice.fr
authors.forename: N
authors.initials: N
authors.lastname: Chevalier
authors.forename: S
authors.initials: S
authors.lastname: Hieronimus
authors.forename: F
authors.initials: F
authors.lastname: Vandenbos
authors.forename: E
authors.initials: E
authors.lastname: Delmont
authors.forename: E
authors.initials: E
authors.lastname: Cua
authors.forename: F
authors.initials: F
authors.lastname: Cherick
authors.forename: P
authors.initials: P
authors.lastname: Paquis
authors.forename: J-F
authors.initials: JF
authors.lastname: Michiels
authors.forename: P
authors.initials: P
authors.lastname: Fenichel
authors.forename: F
authors.initials: F
authors.lastname: Brucker-Davis
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000473:pathology; D003711:Demyelinating Diseases / Q000209:etiology* / Q000473:pathology; D004679:Encephalomyelitis / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000150:complications; D047748:Pituitary ACTH Hypersecretion / Q000150:complications* / Q000473:pathology / Q000601:surgery; D011618:Psychotic Disorders / Q000150:complications; D013406:Suicide, Attempted
chemical_list: D001786:Blood Glucose; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone