The Cushing Syndrome Induced by Atrial Natriuretic Peptide-Producing Thymic Carcinoid

Abstract

Letters1 July 1994The Cushing Syndrome Induced by Atrial Natriuretic Peptide-Producing Thymic CarcinoidShuichi Okada, MD, Kihachi Ohshima, MD, and Masatomo Mori, MDShuichi Okada, MDGunma University of School of Medicine; Showa-machi, Maebashi 371; JapanSearch for more papers by this author, Kihachi Ohshima, MDGunma University of School of Medicine; Showa-machi, Maebashi 371; JapanSearch for more papers by this author, and Masatomo Mori, MDGunma University of School of Medicine; Showa-machi, Maebashi 371; JapanSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-1-199407010-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 75-year-old Japanese man was hospitalized for hypokalemia. Levels of plasma adrenocorticotropic hormone (ACTH) and free cortisol in urine were elevated to 220 pg/mL (normal, 9 to 52 pg/mL) and 793 mg/d (normal, 30 to 100 mg/d), respectively. Blood concentration of corticotropin-releasing factor was 13.8 pg/mL (normal, <40 pg/mL). Chest radiographs and computed tomographic examinations showed an enlarged thymic gland and normal-sized adrenal glands. Venous samplings in the superior and inferior vena cava at several levels showed markedly increased plasma atrial natriuretic peptide concentrations near the thymic tumor (from 120 to 620 pg/mL). By contrast, plasma ACTH ...