A juvenile case of Cushing's disease incidentally discovered with multiple bone fractures

Intern Med. 2007;46(9):583-7. doi: 10.2169/internalmedicine.46.1824. Epub 2007 May 1.

Abstract

A 19-year-old woman who had decreased eight centimeters in stature was diagnosed as Cushing's disease with multiple spine compression fractures. At the age of 18, the patient had a complex fracture and gradually presented the features of Cushing's syndrome. Her plasma ACTH and cortisol levels were extremely high. Radiological findings and chemical markers for bone metabolism showed severe osteoporosis. Magnetic resonance imaging showed the presence of a pituitary microadenoma. After transsphenoidal surgery was performed, subsequently all endocrine data improved. This case indicates that Cushing's syndrome should be considered for severe osteoporotic juvenile patients.

Publication types

  • Case Reports

MeSH terms

  • Absorptiometry, Photon
  • Adenoma / diagnosis
  • Adenoma / surgery
  • Adrenocorticotropic Hormone / blood
  • Adult
  • Cushing Syndrome / complications
  • Cushing Syndrome / diagnosis
  • Female
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / etiology
  • Humans
  • Hydrocortisone / blood
  • Incidental Findings*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Magnetic Resonance Imaging
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / etiology
  • Pituitary ACTH Hypersecretion / blood
  • Pituitary ACTH Hypersecretion / complications*
  • Pituitary ACTH Hypersecretion / diagnosis*
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries*

Substances

  • Adrenocorticotropic Hormone
  • Hydrocortisone