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促肾上腺皮质激素依赖性异位库欣综合征:一例报告

Adrenocorticotropin-Dependent Ectopic Cushing's Syndrome: A Case Report.

作者信息

Rebelo Matos André, Martins André, Barbosa Maria J, Quinteiro Inês, Faustino Diogo, Gameiro Rita, Azevedo Luísa

机构信息

Internal Medicine Department, Hospital São José, Centro Hospitalar Universitário de Lisboa Central, Entidades Públicas Empresariais (EPE), Lisbon, PRT.

Critical Care Medicine Department, Hospital São José, Centro Hospitalar Universitário de Lisboa Central, Entidades Públicas Empresariais (EPE), Lisbon, PRT.

出版信息

Cureus. 2023 Nov 20;15(11):e49124. doi: 10.7759/cureus.49124. eCollection 2023 Nov.

Abstract

Paraneoplastic syndromes are rare and diverse conditions caused by either an abnormal chemical signaling molecule produced by tumor cells or a body's immune response against the tumor itself. These syndromes can manifest in a variable, multisystemic and often nonspecific manner posing a diagnostic challenge. We report the case of an 81-year-old woman who exhibited severe hypokalemia, metabolic alkalosis, and worsening hyperglycemia. The investigation was consistent with adrenocorticotropin (ACTH)-dependent Cushing's syndrome and, eventually, the patient was diagnosed with stage IV primary small-cell lung cancer (SCLC). SCLC is known to be associated with paraneoplastic syndromes, including Cushing's syndrome caused by ectopic adrenocorticotropin (ACTH) secretion. Despite being associated with very poor outcomes, managing these syndromes can be challenging and may hold prognostic significance.

摘要

副肿瘤综合征是由肿瘤细胞产生的异常化学信号分子或机体针对肿瘤本身的免疫反应引起的罕见且多样的病症。这些综合征可表现为多变、多系统且通常非特异性的方式,给诊断带来挑战。我们报告了一例81岁女性病例,该患者出现严重低钾血症、代谢性碱中毒和血糖恶化。检查结果符合促肾上腺皮质激素(ACTH)依赖性库欣综合征,最终,该患者被诊断为IV期原发性小细胞肺癌(SCLC)。已知SCLC与副肿瘤综合征有关,包括由异位促肾上腺皮质激素(ACTH)分泌引起的库欣综合征。尽管这些综合征与非常差的预后相关,但对其进行管理可能具有挑战性,且可能具有预后意义。

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