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Thursday, January 15, 2015

38 Year Old Male (Known Case Of COPD) Presents With Weight Gain


This 38 years old man presents with unintentional weight gain over the past few months. He is a known case of COPD and is on steroid medicines.

Case Discussion:
Cushing Syndrome:

A condition that results from hypercortisolism and the most common cause is exogenous steroid use.

Clinical features:
Patients has typical features of truncal obesity with moon facies and a buffalo hump. Other signs and symptoms include hypertension, psychiatric disturbances, impotence, hirsutism, easy brusibility and purple striae.

Diagnosis:
1. Elevated 24 hour urine cortisol is diagnostic for cushing 's syndrome.
2. Low DHEA is seen only with exogenous steroids.
3. Morning serum ACTH levels are < 5 pg/ml in exogenous steroids or adrenal adenoma.


Treatment:
1. Stop or minimize exogenous steroid use.
2. surgical resection of the tumor responsible for excess hormone production..

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