title: Cushing's syndrome in a morbidly obese patient undergoing evaluation before bariatric surgery.
abstract: OBJECTIVE
  Cushing's syndrome (CS) is extremely rare in morbidly obese patients. To date, no occurrences in obese patients with BMI above 60 kg/m2 have been reported in the literature.
  
  
  METHODS
  This case report describes a patient who was admitted to the ward of the Clinical Division of Endocrinology and Metabolism of the Medical University of Vienna in preparation for bariatric surgery. The patient was a 49-year-old female who showed morbid obesity (BMI 61.6 kg/m2), hypertension, and substituted hypothyroidism. Preoperative work-up revealed CS due to an adrenal adenoma. Therefore, the patient underwent unilateral adrenalectomy followed by bariatric surgery 6 months later.
  
  
  CONCLUSIONS
  Since undiagnosed CS might result in severe perioperative complications in a population already at increased risk, this case report underlines the importance of careful endocrine evaluation of morbidly obese patients. After all, even rare endocrine causes should be excluded.
authors.affiliation: Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Livia
authors.initials: L
authors.lastname: Borsoi
authors.forename: Bernhard
authors.initials: B
authors.lastname: Ludvik
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
authors.forename: Michaela
authors.initials: M
authors.lastname: Riedl
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000601:surgery; D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000097:blood; D001317:Austria; D015992:Body Mass Index; D000075202:Contraindications; D003480:Cushing Syndrome / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D003907:Dexamethasone; D005260:Female; D015390:Gastric Bypass; D050031:Hashimoto Disease / Q000150:complications; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension / Q000150:complications; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*
chemical_list: D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone