Клиническое наблюдение тяжелого течения болезни Иценко — Кушинга

Abstract

Cushing's disease is a severe neuroendocrine disorder caused by excessive release of adrenocorticotropic hormone by pituitary tumor. The rate is 39.1 per 1 million and the incidence is 1.2–2.4 per 1 million. Typical symptoms include rapid weight gain associated with muscle weakness, hypertension, diabetes, and osteoporosis. The key diagnostic tool is brain MRI after laboratory confirmation of a diagnosis of hypercortisolemia. The key treatment is transsphenoidal adenomectomy, which provides remission in 65–90% of patients. This paper describes the severe course of Cushing's disease in a male patient, which has long remained undiagnosed. Diagnostic search steps, differential diagnostic difficulties, and follow-up results (including inferior petrosal sinus sampling) are discussed. A multidisciplinary approach and teamwork ensure timely diagnosis, prevent complications of Cushing's disease, and improve prognosis and quality of life. KEYWORDS: Cushing's disease, case report, hypercortisolism, hypercortisolemia, ACTH, somatostatin receptor scintigraphy, transsphenoidal adenomectomy FOR CITATION: Gorbunova N.P., Prokhorova G.V., Zubkova A.S., Korotkikh S.M., Volynkina A.P., Reshetnyak Ya.Ya. Case report of a severe course of Cushing's disease. Russian Medical Inquiry. 2023;7(9):606–610 (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-8.