title: Hypercortisolism Manifesting as Severe Weight Loss, Hypokalemia, and Hyperglycemia in the Emergency Department.
abstract: BACKGROUND
  The concurrence of ectopic adrenocorticotropic hormone (ACTH) syndrome (ectopic Cushing syndrome) and cancer is uncommon in the emergency department (ED) setting, but a constellation of nonspecific signs and symptoms can suggest the presence of Cushing syndrome.
  
  
  METHODS
  A 65-year-old woman with diabetes visited the ED complaining of severe weight loss, generalized weakness, and hypokalemia. She was treated for hypokalemia and thrush. She was found to have a lung mass with a large pleural effusion. Upon discovery of the suspected malignancy, the patient was referred to the ED of a comprehensive cancer center, where she was diagnosed with ectopic Cushing syndrome and admitted to the hospital for further evaluation and treatment. WHY SHOULD THE EMERGENCY PHYSICIAN BE AWARE OF THIS?: The emergency physician should be able to recognize Cushing syndrome in cancer patients so that the paraneoplastic syndrome can be managed to avoid complications during cancer treatment.
authors.affiliation: Department of Emergency Medicine, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Adam H
authors.initials: AH
authors.lastname: Miller
authors.affiliation: Department of Emergency Medicine, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Sai-Ching J
authors.initials: SC
authors.lastname: Yeung
mesh_terms: D000368:Aged; D003480:Cushing Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis; D007008:Hypokalemia / Q000175:diagnosis; D015431:Weight Loss
keywords: Cushing syndrome; ectopic Cushing syndrome; hypercortisolism; hyperglycemia; hypokalemia; lung cancer; malignancy; weight loss