Borsoi Livia, Ludvik Bernhard, Prager Gerhard, Luger Anton, Riedl Michaela
Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
Obes Facts. 2014;7(3):191-6. doi: 10.1159/000363260. Epub 2014 Jun 4.
Cushing's syndrome (CS) is extremely rare in morbidly obese patients. To date, no occurrences in obese patients with BMI above 60 kg/m2 have been reported in the literature.
This case report describes a patient who was admitted to the ward of the Clinical Division of Endocrinology and Metabolism of the Medical University of Vienna in preparation for bariatric surgery. The patient was a 49-year-old female who showed morbid obesity (BMI 61.6 kg/m2), hypertension, and substituted hypothyroidism. Preoperative work-up revealed CS due to an adrenal adenoma. Therefore, the patient underwent unilateral adrenalectomy followed by bariatric surgery 6 months later.
Since undiagnosed CS might result in severe perioperative complications in a population already at increased risk, this case report underlines the importance of careful endocrine evaluation of morbidly obese patients. After all, even rare endocrine causes should be excluded.
库欣综合征（CS）在病态肥胖患者中极为罕见。迄今为止，文献中尚未报道过BMI高于60kg/m²的肥胖患者出现该病症。
本病例报告描述了一名准备接受减肥手术而入住维也纳医科大学内分泌与代谢临床科病房的患者。该患者为49岁女性，表现为病态肥胖（BMI 61.6kg/m²）、高血压和亚临床甲状腺功能减退。术前检查发现因肾上腺腺瘤导致的CS。因此，患者接受了单侧肾上腺切除术，6个月后进行了减肥手术。
由于未诊断出的CS可能在本就风险增加的人群中导致严重的围手术期并发症，本病例报告强调了对病态肥胖患者进行仔细内分泌评估的重要性。毕竟，即使是罕见的内分泌病因也应排除。
