PDF(Pubmed)
Abstract：
Cushing\'s syndrome (CS) arises from an excess of endogenous or exogenous cortisol, with Cushing\'s disease specifically implicating a pituitary adenoma and exaggerated adrenocorticotropic hormone (ACTH) production. Typically, Cushing\'s disease presents with characteristic symptoms such as weight gain, central obesity, moon face, and buffalo hump. This case report presents an unusual manifestation of CS in a 48-year-old male with a history of hypertension, where severe hypokalemia was the primary presentation. Initial complaints included bilateral leg swelling, muscle weakness, occasional shortness of breath, and a general feeling of not feeling well. Subsequent investigations revealed hypokalemia, metabolic alkalosis, and an abnormal response to dexamethasone suppression, raising concerns about hypercortisolism. Further tests, including 24-hour urinary free cortisol and ACTH testing, confirmed significant elevations. Brain magnetic resonance imaging (MRI) identified a pituitary macroadenoma, necessitating neurosurgical intervention. This case underscores the rarity of CS presenting with severe hypokalemia, highlighting the diagnostic challenges and the crucial role of a collaborative approach in managing such intricate cases.
摘要：
库欣综合征（CS）由内源性或外源性皮质醇过量引起，库欣病特别涉及垂体腺瘤和过度的促肾上腺皮质激素（ACTH）产生。通常,库欣病表现出特征性症状，如体重增加，中心性肥胖,月亮的脸,还有水牛驼峰.该病例报告在一名有高血压病史的48岁男性中表现出不寻常的CS。严重低钾血症是主要表现。最初的投诉包括双侧腿部肿胀，肌肉无力,偶尔呼吸急促,还有一种不舒服的感觉。随后的调查显示低钾血症，代谢性碱中毒，和对地塞米松抑制的异常反应，引起人们对皮质醇增多症的担忧。进一步的测试,包括24小时尿游离皮质醇和ACTH测试，证实了显著的海拔。脑磁共振成像（MRI）确定了垂体大腺瘤，需要神经外科干预。该病例强调了罕见的CS表现为严重的低钾血症，强调诊断挑战和协作方法在管理此类复杂病例中的关键作用。
