KMID : 0384320030240080746
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Korean Journal of Family Medicine 2003 Volume.24 No. 8 p.746 ~ p.751
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Cushing Disease Diagnosed with Bilateral Simultaneous Inferior Petrosal Sinus Sampling
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Kim Seon-Mee
Lee Seung-Hwan Jung Hoe-Hyun Lee Woo-Kyung Hong Myung-Ho
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Abstract
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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.
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KEYWORD
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cushing¡¯s syndrome, cushing¡¯s disease
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