A case of posttraumatic acth deficiency that initial skin finding suggesting cushing syndrome
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Dosyalar
Tarih
2016
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hipofizer adrenokortikotropik hormon (ACTH) eksikliği sekonder adrenal yetmezlik nedenlerinden birisidir. Genetik nedenler, otoimmünite, infiltratif hastalıklar, kafa travmaları ACTH yetmezliğine neden olabilmektedir. Primer adrenal yetmezlikte hiperpigmente deri lezyonları beklenirken, sekonder adrenal yetmezlikte çok nadirdir. Strialar derinin gerilimine dik olarak yerleşmiş atrofik bandlardır ve patogenezi tam olarak açıklanmamıştır. Çoğunlukla obezite, gebelik, hiperkortizolizm ile ilişkilidir. Hipokortizolemide stria beklenen bir bulgu değildir. Bu yazımızda, her iki koltukaltındaki striaları nedeniyle değerlendirdiğimiz 34 yaşındaki erkek olguyu sunduk. Olgunun öyküsünde 12 yıl önce geçirdiği kafa travması ve ameliyat öyküsü mevcuttu. Bazal kortizol ve ACTH düzeyleri sırasıyla 0,18 ug/dl and <1,6 pg/ml idi. ACTH uyarı testinde, adrenal bezin kortizol cevabı suboptimaldi. Sonuç olarak, striaları nedeniyle Cushing Sendromu düşünerek araştırdığımız olguya, postravmatik ACTH yetmezliğine bağlı hipokortizolemi tanısı koyduk ve takibe aldık
Pituitary adrenocorticotropic hormone (ACTH) deficiency is one cause of secondary adrenal insufficiency. Genetic factors, autoimmunity, infiltrative disease, cranial trauma may cause ACTH deficiency. Hyperpigmented skin lesions are expected in primary adrenal insufficiency while they are very rare in secondary adrenal insufficiency. Striae are characterized by linear smooth bands of atrophic appearing skin and pathogenesis is not understood. They are mostly associated with obesity, pregnancy, hypercortisolism. Striae are not an expected finding in hypocortisolemia. We presented a 34-year-old male patient that evaluated for striae on both axillas. He had head trauma and operation 12 years ago. Basal hypophysis hormone levels and dynamic tests were conducted. Basal cortisol and ACTH level were 0,18 ug/dl and <1,6 pg/ml, respectively. Adrenal gland had a suboptimal cortisol response in ACTH stimulation test. Conclusively, we diagnosed and followed a case of posttraumatic ACTH deficiency with hypocortisolemia that investigated with suspect of Cushing Syndrome due to striae on his skin
Pituitary adrenocorticotropic hormone (ACTH) deficiency is one cause of secondary adrenal insufficiency. Genetic factors, autoimmunity, infiltrative disease, cranial trauma may cause ACTH deficiency. Hyperpigmented skin lesions are expected in primary adrenal insufficiency while they are very rare in secondary adrenal insufficiency. Striae are characterized by linear smooth bands of atrophic appearing skin and pathogenesis is not understood. They are mostly associated with obesity, pregnancy, hypercortisolism. Striae are not an expected finding in hypocortisolemia. We presented a 34-year-old male patient that evaluated for striae on both axillas. He had head trauma and operation 12 years ago. Basal hypophysis hormone levels and dynamic tests were conducted. Basal cortisol and ACTH level were 0,18 ug/dl and <1,6 pg/ml, respectively. Adrenal gland had a suboptimal cortisol response in ACTH stimulation test. Conclusively, we diagnosed and followed a case of posttraumatic ACTH deficiency with hypocortisolemia that investigated with suspect of Cushing Syndrome due to striae on his skin
Açıklama
Anahtar Kelimeler
Striae, Cushing Syndrome, Posttraumatic Acth Deficiency, Stria, Cushing Sendromu, Posttravmatik Acth Eksikliği
Kaynak
İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
3
