Abstract
OBJECTIVE: To describe a patient with Cushing disease who had an exacerbation of Graves disease following surgical resection of a corticotroph pituitary adenoma. METHODS: We present the clinical and biochemical findings of this case, with review of the pertinent literature. RESULTS: A 39-year-old woman with a history of Graves disease on methimazole presented with a 100-pound weight gain over 12 months. Biochemical evaluation revealed Cushing disease, and she underwent an uncomplicated trans-sphenoidal pituitary adenomectomy surgery. Seven weeks after operation, she presented with an adrenal crisis, despite taking 30 mg of hydrocortisone daily, as a likely consequence of worsening hyperthyroidism despite continued methimazole treatment. CONCLUSION: A combination of Graves disease and Cushing syndrome can be a challenging scenario. Successful treatment of hypercortisolism can lead to an exacerbation of hyperthyroidism, with a resultant increase in cortisol clearance, which, in this circumstance, may precipitate an adrenal crisis. Clinicians should be aware of these interactions and monitor such patients closely.
Original language | English (US) |
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Pages (from-to) | 206-208 |
Number of pages | 3 |
Journal | Endocrinologist |
Volume | 17 |
Issue number | 4 |
DOIs | |
State | Published - Jul 2007 |
Externally published | Yes |
Keywords
- Adrenal crisis
- Adrenal insufficiency
- Cushing disease
- Graves disease
- Pituitary surgery
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism