KMID : 1012420160250030150
|
|
Korean Journal of Obesity 2016 Volume.25 No. 3 p.150 ~ p.153
|
|
Endogenous Cushing¡¯s Syndrome in a Patient with Systemic Lupus Erythematosus
|
|
Kang Eun-Jin
Moon Su-Jin Moon Kyung-Ho Han Deok-Jae Lee Ja-In Ro Sang-Mi Son Jang-Won Kim Sung-Rae Min Jun-Ki Yoo Soon-Jib
|
|
Abstract
|
|
|
Systemic lupus erythematosus is an autoimmune disease for which glucocorticoids are the mainstay of treatment. Cushing¡¯s syndrome is caused by glucocorticoid excess, which can be either exogenous or endogenous. Although iatrogenic Cushing¡¯s syndrome is the most common form, especially in patients undergoing glucocorticoid treatment, endogenous glucocorticoid excess should be considered because it has a different treatment strategy. We describe a 51-year old woman with a longstanding history of SLE. She was treated with steroid and cytoxan pulse therapy and plasmapheresis. Her lupus activity had been stable for 7 years with low-dose glucocorticoid treatment. She showed excessive weight gain, easy bruising, moon facies, truncal obesity, acne, and menstrual disorder. Given her history of long-term steroid therapy, iatrogenic Cushing¡¯s syndrome was considered the most likely diagnosis; however, worsening features of Cushing¡¯s syndrome with a minimal dose of glucocorticoid led us to diagnose endogenous Cushing¡¯s syndrome due to a left adrenal adenoma. The patient underwent laparoscopic left adrenalectomy. Her SLE was controlled with transient low-dose glucocorticoid treatment, and her lupus activity remained stable without glucocorticoid treatment. This is the first reported case of concomitant endogenous Cushing¡¯s syndrome in a patient with preexisting SLE in Korea. This case shows the importance of differential diagnosis including exogenous Cushing¡¯s syndrome and endogenous Cushing¡¯s syndrome in autoimmune disease patients with glucocorticoid therapy.
|
|
KEYWORD
|
|
Cushing¡¯s syndrome, Systemic lupus erythematosus, Glucocorticoid therapy, Differential diagnosis
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|