Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Mod Rheumatol Case Rep. 2020 Jan;4(1):16-20. doi: 10.1080/24725625.2019.1638049. Epub 2019 Jul 11.
An 18-year-old female was diagnosed with subclinical Cushing's syndrome (CS) due to a left adrenal adenoma. When she was 20 years old, she developed lupus nephritis. She was treated with high-dose prednisolone (PSL) and soon developed the symptoms of CS. When she was 25 years old, we evaluated her serum glucocorticoid level while she continued to take oral PSL. The result suggested her CS was affected by both the oral PSL and the endogenous cortisol secreted by the adrenocortical adenoma, which was therefore resected. Seven months after the operation, the patient's body weight was decreasing, and her SLE remained in clinical remission. CS complicated by SLE is rare, and the decision to surgically remove an adrenal tumor in such a case is even more rare.
一位 18 岁女性因左肾上腺腺瘤被诊断为亚临床库欣综合征(CS)。20 岁时,她患狼疮性肾炎。她接受了大剂量泼尼松龙(PSL)治疗,很快出现 CS 症状。25 岁时,我们在她继续服用口服 PSL 的同时评估了她的血清糖皮质激素水平。结果表明,她的 CS 既受口服 PSL 的影响,也受肾上腺腺瘤分泌的内源性皮质醇的影响,因此进行了切除。术后 7 个月,患者体重下降,SLE 仍处于临床缓解期。CS 合并 SLE 较为罕见,在这种情况下决定手术切除肾上腺肿瘤更为罕见。