KMID : 0438420140210040277
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Korean Journal of Bone Metabolism 2014 Volume.21 No. 4 p.277 ~ p.282
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Mutiple Spontaneous Rib Fractures in Patient with Cushing¡¯s Syndrome
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Lee Hyun-Jung
Je Ji-Hye Seo Ji-Hye Na Young-Ju Yoo Hye-Jin
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Abstract
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Glucocorticoid (GC) excess, including Cushing¡¯s syndrome, is a common cause of secondary osteoporosis. Thirty to fifty percent of Cushing¡¯s syndrome patients experience non-traumatic fractures, which is often the presenting manifestation of Cushing¡¯s syndrome. However, there have been rare cases of Cushing¡¯s syndrome diagnosed only based upon bone manifestations. We describe a case of Cushing¡¯s syndrome that was diagnosed in a 44-year-old woman who initially visited our hospital due to multiple non-traumatic rib fractures. She did not exhibit any other manifestations of Cushing¡¯s syndrome such as moon face, buffalo hump or abdominal striae. Initially, we evaluated her for bone metastases from a cancer of unknown origin, but there was no evidence of metastatic cancer. Instead, we found a left adrenal incidentaloma. As a result of the hormone study, she was diagnosed as having Cushing¡¯s syndrome. Interestingly, her bony manifestation of Cushing¡¯s syndrome, which was evident in the bone scan and bone mineral densitometry, completely recovered after a left adrenalectomy. Therefore, the possibility of Cushing¡¯s syndrome as a cause of secondary osteoporosis should be considered in young patients with non-traumatic multiple fractures, with or without any other typical features of Cushing¡¯s syndrome.
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KEYWORD
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Cushing syndrome, Fractures spontaneous, Osteoporosis
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