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Spontaneous Remission Of Unidentified Cushing’s Disease Revealed By Hair Cortisol Analysis

Van & Oven, 2020Brain tumor

van Boven, E., Massolt, E. T., van Rossum, E. F. C., & Kiewiet-Kemper, R. M. (2020). Spontaneous remission of unidentified Cushing's disease revealed by hair cortisol analysis. The Netherlands journal of medicine, 78(5), 297–299.

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Case Details

Disease Location

Pituitary gland

Personal Characteristics

31-year-old woman, hypertension, type 2 diabetes mellitus, polycystic ovary syndrome, and hypothyroidism, all diagnosed within a timeframe of three years.

Clinical Characteristics

Admitted with a thunderclap headache. MRI showed pituitary apoplexy in a pituitary macro adenoma. Physical examination was suggestive of cushing’s syndrome. Laboratory testing was consistent with complete anterior hypopituitarism. Hydrocortisone therapy of 80 mg a day was started. Hair cortisol analysis was performed the results showed cyclic but significantly and consistently elevated cortisol levels for the last 22 months. The diagnosis of cushing’s disease in our patient cured by pituitary apoplexy.

Remission Characteristics

Diagnosis of cushing’s disease cured by pituitary apoplexy was established

Treatment & Mechanisms

Proposed Remission Mechanisms

Pituitary apoplexy

Clinical Treatment

Hydrocortisone 80mg/d