ID | 116832 |
タイトル別表記 | A case of Cushing’s syndrome detected by repeated fragility fractures
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著者 |
木村, 蘭子
徳島大学
細木, 美苗
徳島大学
辻, 誠士郎
徳島大学
三井, 由加里
徳島大学
明比, 祐子
徳島大学
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キーワード | Cushing syndrome
fragility fracture
Premenopausal woman
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資料タイプ |
学術雑誌論文
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抄録 | A 38-year-old woman had suffered from an avulsion fracture of the left cuboid bone, a rib fracture, a fatigue fracture of the left second metatarsal bone and a pubic fracture within the last 4 years. She also realized that her face was getting rounded and became aware of edema on extremities. She had repeated fragile fractures before menopause and was referred to our department on suspicion of secondary osteoporosis. The patients showed physical signs of moon face, central obesity, and abdominal violaceous striae. Cushing’s syndrome was suspected, therefore confirmatory studies were performed. Circadian variation of cortisol : serum cortisol19.3μg/dL(at7:00), 21.4μg/dL(at23:00), urinary free cortisol :247.4μg/24h, ACTH :2.5pg/mL. Low-dose(1mg) dexamethasone did not suppress cortisol level(18.9μg/dL). Based on these findings, we diagnosed as Cushing’s syndrome and glucocorticoid excess seemed to be the cause of secondary osteoporosis. Abdominal CT identified a 2.7 cm tumor in the left adrenal gland, and in-phase T1‐weighted MRI showed decreased signal compared to out-phase, suggesting an adrenocortical adenoma. She underwent laparoscopic left adrenalectomy. Postoperative fasting serum cortisol decreased to2.2 μg/dL, and glucocorticoid replacement therapy was started. It is necessary to find out any secondary causes for premenopausal women with fragility fractures. It is well known that endocrine disorders including Cushing’s syndrome are the most frequent associated diseases in patients with premenopausal osteoporosis. Cushing’s syndrome should be considered as a causative disease in premenopausal women with osteoporosis.
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掲載誌名 |
四国医学雑誌
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ISSN | 00373699
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cat書誌ID | AN00102041
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出版者 | 徳島医学会
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巻 | 77
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号 | 5-6
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開始ページ | 269
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終了ページ | 274
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並び順 | 269
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発行日 | 2021-12-25
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EDB ID | |
フルテキストファイル | |
言語 |
jpn
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著者版フラグ |
出版社版
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部局 |
病院
医学系
先端酵素学研究所
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