直近一年間の累計
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ID 116832
タイトル別表記
A case of Cushing’s syndrome detected by repeated fragility fractures
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
キーワード
Cushing syndrome
fragility fracture
Premenopausal woman
資料タイプ
学術雑誌論文
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
77
5-6
開始ページ
269
終了ページ
274
並び順
269
発行日
2021-12-25
EDB ID
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系
先端酵素学研究所