A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome
Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH) secretion. We report the case of a 65-year-old man, a...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2017-04-01
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| Series: | Case Reports in Oncology |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/467390 |
| _version_ | 1818683421763829760 |
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| author | Christina E. Brzezniak Nicole Vietor Patricia E. Hogan Bryan Oronsky Bennett Thilagar Carolyn M. Ray Scott Caroen Michelle Lybeck Neil Oronsky Corey A. Carter |
| author_facet | Christina E. Brzezniak Nicole Vietor Patricia E. Hogan Bryan Oronsky Bennett Thilagar Carolyn M. Ray Scott Caroen Michelle Lybeck Neil Oronsky Corey A. Carter |
| author_sort | Christina E. Brzezniak |
| collection | DOAJ |
| description | Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH) secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes. Decompensated hyperglycemia suggested a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Additional findings, which included hypokalemia, hypernatremia, hypertension, metabolic alkalosis, moon facies, and striae, raised a red flag for an ectopic ACTH syndrome. Elevated ACTH levels confirmed Cushing syndrome. Treatment with a fluid replacement and insulin drip resulted in immediate symptomatic improvement. Cushing syndrome should be considered in carcinoid patients with physical stigmata such as moon facies and striae. HHNS may be the presenting clinical feature in patients with impaired glucose metabolism. |
| first_indexed | 2024-12-17T10:34:28Z |
| format | Article |
| id | doaj.art-52b5184d27874b77acd2354f8c6ffe81 |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-12-17T10:34:28Z |
| publishDate | 2017-04-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-52b5184d27874b77acd2354f8c6ffe812022-12-21T21:52:25ZengKarger PublishersCase Reports in Oncology1662-65752017-04-0110132132410.1159/000467390467390A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic SyndromeChristina E. BrzezniakNicole VietorPatricia E. HoganBryan OronskyBennett ThilagarCarolyn M. RayScott CaroenMichelle LybeckNeil OronskyCorey A. CarterCarcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH) secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes. Decompensated hyperglycemia suggested a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Additional findings, which included hypokalemia, hypernatremia, hypertension, metabolic alkalosis, moon facies, and striae, raised a red flag for an ectopic ACTH syndrome. Elevated ACTH levels confirmed Cushing syndrome. Treatment with a fluid replacement and insulin drip resulted in immediate symptomatic improvement. Cushing syndrome should be considered in carcinoid patients with physical stigmata such as moon facies and striae. HHNS may be the presenting clinical feature in patients with impaired glucose metabolism.http://www.karger.com/Article/FullText/467390Carcinoid tumorNeuroendocrine tumorCushing syndromeAdrenocorticotrophic hormoneHyperglycemic hyperosmolar nonketotic syndrome |
| spellingShingle | Christina E. Brzezniak Nicole Vietor Patricia E. Hogan Bryan Oronsky Bennett Thilagar Carolyn M. Ray Scott Caroen Michelle Lybeck Neil Oronsky Corey A. Carter A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome Case Reports in Oncology Carcinoid tumor Neuroendocrine tumor Cushing syndrome Adrenocorticotrophic hormone Hyperglycemic hyperosmolar nonketotic syndrome |
| title | A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome |
| title_full | A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome |
| title_fullStr | A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome |
| title_full_unstemmed | A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome |
| title_short | A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome |
| title_sort | case of paraneoplastic cushing syndrome presenting as hyperglycemic hyperosmolar nonketotic syndrome |
| topic | Carcinoid tumor Neuroendocrine tumor Cushing syndrome Adrenocorticotrophic hormone Hyperglycemic hyperosmolar nonketotic syndrome |
| url | http://www.karger.com/Article/FullText/467390 |
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