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KMID : 0384320030240080746
Korean Journal of Family Medicine
2003 Volume.24 No. 8 p.746 ~ p.751
Cushing Disease Diagnosed with Bilateral Simultaneous Inferior Petrosal Sinus Sampling
Kim Seon-Mee

Lee Seung-Hwan
Jung Hoe-Hyun
Lee Woo-Kyung
Hong Myung-Ho
Abstract
The most common endogenous cause of Cushing¡¯s syndrome is Cushing¡¯s disease. The evaluation of patients with suspected Cushing¡¯s disease and syndrome requires an understanding of the proper use and limitations of the tests commonly included in the diagnostic work-up. The best screening test for Cushing¡¯s syndrome is a 24-hour urine collection with analysis for urinary free cortisol excretion. Low-dose and high-dose dexamethasone suppression tests, corticotropin assays, a corticotropin-release hormone stimulation test and inferior petrosal sinus cathaterization may be required for a definitive diagnosis. MRI is useful in localizing the lesion but some limitations. Surgical removal of the lesion by a trans-sphenoidal appraoch is usually successful, but long-term follow-up is required. We report a case of Cushing disease which shows such typical clinical characteristics of Cushing syndrome as weight gain, skin lesions, truncal obesity, striae, hypertension.
KEYWORD
cushing¡¯s syndrome, cushing¡¯s disease
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