Resistant arterial hypertension in obese and type 2 diabetic patients
DOI:
https://doi.org/10.32818/reccmi.a7n1a9Keywords:
cyclic Cushing's syndrome, resistant hypertension, Cushing's diseaseAbstract
We present a case of a 56-year-old man with central obesity and resistant arterial hypertension refractory to quadruple therapy who, in his study, shows a cyclical alternation between periods of normal adrenal function with periods of hypercortisolism compatible with the diagnosis of cyclic Cushing's syndrome.
This case report shows periodical hormone test is recommended in patients where Cushing syndrome is suspected. This practice allows to identify this disease, many times under diagnosed.
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Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Press. 2018; 27(6): 314-340. doi: https://doi.org/10.1080/08037051.2018.1527177.
Ceccato F, Boscaro M. Cushing's Syndrome: Screening and Diagnosis. High Blood Press Cardiovasc Prev. 2016; 23(3): 209-15. doi: https://doi.org/10.1007/s40292-016-0153-4.
Nieman LK. Hypertension and Cardiovascular Mortality in Patients with Cushing Syndrome. Endocrinol Metab Clin North Am. 2019; 48(4): 717-725. doi: https://doi.org/10.1016/j.ecl.2019.08.005.
Bailey RE. Periodic hormonogenesis - a new phenomenon. Periodicity in function of a hormone-producing tumor in man. J Clin Endocrinol Metab. 1971; 32(3): 317-27. doi: https://doi.org/10.1210/jcem-32-3-317.
Alexandraki KI, Kaltsas GA, Isidori AM, Akker SA, Drake WM, Chew SL, et al. The prevalence and characteristic features of cyclicity and variability in Cushing's disease. Eur J Endocrinol. 2009; 160(6): 1011-8. doi: https://doi.org/10.1530/EJE-09-0046.
Meinardi JR, Wolffenbuttel BH, Dullaart RP. Cyclic Cushing's syndrome: a clinical challenge. Eur J Endocrinol. 2007; 157(3): 245-54. doi: https://doi.org/10.1530/EJE-07-0262.
Atkinson B, Mullan KR. What is the best approach to suspected cyclical Cushing syndrome? Strategies for managing Cushing's syndrome with variable laboratory data. Clin Endocrinol (Oxf). 2011; 75(1): 27-30. doi: https://doi.org/10.1111/j.1365-2265.2011.04033.x.
Arnaldi G, Mancini T, Kola B, Appolloni G, Freddi S, Concettoni C et al. Cyclical Cushing's syndrome in a patient with a bronchial neuroendocrine tumor (typical carcinoid) expressing ghrelin and growth hormone secretagogue receptors. J Clin Endocrinol Metab. 2003; 88(12): 5834-40. doi: https://doi.org/10.1210/jc.2003-030514.
Meinardi JR, van den Berg G, Wolffenbuttel BH, Kema IP, Dullaart RP. Cyclical Cushing's syndrome due to an atypical thymic carcinoid. Neth J Med. 2006; 64(1): 23-7.
Nieman LK, Biller BM, Findling JW, Murad MH, Newell-Price J, Savage Moet al; Endocrine Society. Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015; 100(8): 2807-31. doi: https://doi.org/10.1210/jc.2015-1818.
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Copyright (c) 2022 Sara Luis-García, Leyre Alonso-Gonzalo, Candela González-San Narciso, Fernando Jiménez-Segovia, Ana Torres-Do Rego
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