Syndrome of ectopic production of the adrenocorticotropic hormone with hypercorticism
https://doi.org/10.18705/1607-419X-2021-27-2-239-246
Abstract
The syndrome of the ectopic production of the adrenocorticotropic hormone (ACTH) presents a version of endogenous hypercorticism which is the most challenging one for diagnostics and treatment. The paper discusses a clinical case of the ACTH-ectopic syndrome diagnosed in an elderly female patient. Advanced age and ongoing long-term treatment may obscure the typical manifestations of a disease. At the same time, it is common for doctors to be less focused on identifying rare diseases when working with elderly patients. A combination of clinical signs (resistance to the antihypertensive therapy; poorly controlled glycemia; increasing weakness; hypokalemia and severe skin pigmentation) allowed for suspecting symptomatic hypertension. Doctors need to be alert and to identify rare diseases among patients of any age group. This case also demonstrates the productivity of a multidisciplinary approach (a team including cardiologists, endocrinologists, radiology specialists and surgeons).
About the Authors
I. Y. Lukianova
North-Western State Medical University named after I. I. Mechnikov; Saint-Petersburg State University
Russian Federation
Russian Federation
Irina Y. Lukianova, MD, PhD, DSc, Associate Professor, Emergency Medicine Department; Associate Professor, Department of Internal Medicine
41 Kirochnaya str., St Petersburg, 4191015 Russia
T. P. Bulach
North-Western State Medical University named after I. I. Mechnikov
Russian Federation
Russian Federation
Tamara P. Bulach, MD, PhD, DSc, Associate Professor, Emergency Medicine Department
St Petersburg
O. I. Semenova
Aleksandrovskii City Hospital № 17
Russian Federation
Russian Federation
Olga I. Semenova, MD, Head, Department of Endocrinology
St Petersburg
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For citations:
Lukianova I.Y., Bulach T.P., Semenova O.I. Syndrome of ectopic production of the adrenocorticotropic hormone with hypercorticism. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2021;27(2):239-246. (In Russ.) https://doi.org/10.18705/1607-419X-2021-27-2-239-246
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