Bala Margarita, Bollheimer Cornelius, Schölmerich Jürgen, Schäffler Andreas
Margarita Bala, Cornelius Bollheimer, Jürgen Schölmerich, Andreas Schäffler.
Med Klin (Munich). 2009 Mar 15;104(3):244-8. doi: 10.1007/s00063-009-1038-2. Epub 2009 Apr 1.
A 28-year-old woman was referred to hospital with a spontaneous femoral neck fracture. Dual energy X-ray absorptiometry showed severe osteoporosis without apparent cause or risk factors. The basic endocrinologic evaluation revealed hypercortisolism, and the diagnosis of Cushing's disease could be made following biochemical test and magnetic resonance imaging. A transsphenoidal resection of the pituitary gland tumor was performed and led to a cure of the disease. The patient received calcium and vitamin D substitution as well as biphosphonates.
Glucocorticoid-induced osteoporosis is the most frequent cause of secondary osteoporosis. Only few cases with occult endogenous Cushing's syndrome and osteoporosis as the main manifestation of the disease have been reported. Nevertheless, hypercortisolism should be excluded whenever osteoporosis without apparent cause is diagnosed.
一名28岁女性因自发性股骨颈骨折被转诊至医院。双能X线吸收测定显示严重骨质疏松，无明显病因或危险因素。基础内分泌学评估显示皮质醇增多症，经生化检查和磁共振成像后确诊为库欣病。进行了经蝶窦垂体肿瘤切除术，疾病得以治愈。患者接受了钙和维生素D补充以及双膦酸盐治疗。
糖皮质激素诱导的骨质疏松是继发性骨质疏松最常见的原因。仅有少数以隐匿性内源性库欣综合征和骨质疏松为主要表现的病例报道。然而，一旦诊断出无明显病因的骨质疏松，应排除皮质醇增多症。
