ECE2007 Poster Presentations (1) (659 abstracts)
Paraneoplastic Cushing’s syndrome presenting as psychosis – case report
Cristina Spiroiu , Aurelian Emil Ranetti , Ana- Maria Mihai , Adina Mazilu & Nicolae Diaconu
Central Military Emergency Hospital, Bucharest, Romania.
We present the case of a 51 years old woman, nonsmoker, without relevant past medical history, who presented with acute psychotic state starting the third day of treatment with prednisone 30 mg indicated for allergy. She had also arterial hypertension and a significant and progressive loss of proximal muscle strength in her legs. The initial evaluation showed hyperglycemia, metabolic alkalosis and severe hypokalemia. Basal plasma cortisol was high (>90 μg/dl) and did not suppress after high dose of dexamethasone. Abdominal computed tomography revealed bilateral adrenal hyperplasia; thoracic computed tomography showed a lung mass, which proved to be a small cell lung carcinoma at fiberoptic bronchoscopy with brushing and cytology exam. The psychotic state resolved in a couple of days; despite intensive oral and intravenous potassium supplement, high doses of spironolactone and aminoglutethimide, the serum level of potassium increase but did not normalize. Combination chemotherapy did not improve the patient’s condition. She died a month later of severe lung infection.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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