We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing’s syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.
Citations
Citations to this article as recorded by
A Scoping Review of Self-Medication in Exogenous Cushing Syndrome: The Role of Social Determinants of Health in the Case Report Literature Meghana Koleti, Claramence Dokyi, Jean Kim, L. Maria Belalcazar Endocrine Practice.2025;[Epub] CrossRef
Glucocorticoid-Induced Side Effects Cause Oral Lesions in Systemic Lupus Erythematosus: A Case Report Zulfa Pranadwista, Novia Hasanah, Tenny Dewi, Wahyu Hidayat International Medical Case Reports Journal.2024; Volume 17: 919. CrossRef
A patient with a bronchial carcinoid presents with Cushingoid symptoms due to an atypical and potentially dangerous supplement Tomas Morales, Shanika Samarasinghe Journal of Clinical and Translational Endocrinology: Case Reports.2023; 30: 100157. CrossRef
Mammary Paget’s disease is clinically defined as skin inflammation of the nipple area and is an adenocarcinoma of the epidermis of the nipple. The pathogenesis of mammary Paget’s disease is relatively unknown; nonetheless, there are two popular theories that support the underlying carcinoma and de novo carcinogenesis. For the attending medical practitioner, mammary Paget’s disease poses a diagnostic and therapeutic dilemma, especially in the absence of a clinically palpable breast mass. We report a rare case of a 48-year-old Malay woman who presented at Hospital Universiti Sains Malaysia, Kelantan, Malaysia with the symptom of skin erosion on the left nipple and unresponsiveness to multiple topical treatments. A full evaluation and assessment of the patient were conducted, and mammary Paget’s disease was diagnosed.
Citations
Citations to this article as recorded by
Diagnostic imaging challenges of mammary Paget's disease presenting with subtle clinical and imaging features: A case report Sawitri Darmiati, Andre Elton Heryanto, Primariadewi Rustamadji Radiology Case Reports.2025; 20(4): 1925. CrossRef
Dermatologic diseases of the breast, areola and nipple Jenny Deluca, Maria Pichler, Elga Bataraga, Mario Puviani, Klaus Eisendle JDDG: Journal der Deutschen Dermatologischen Gesellschaft.2025; 23(5): 621. CrossRef
Mammary Paget’s disease in a young woman: A rare occurrence Chaimae Abourak, Aya Laridi, Ouafaa Chahboune, Siham Oukassem, Asmae Guennouni, Soukaina Bahha, Lina Belkouchi, Nazik Allali, Latifa Chat, Siham El Haddad Radiology Case Reports.2025; 20(8): 3733. CrossRef
Dermatologische Erkrankungen von Brust, Areola mammae und der Mamille Jenny Deluca, Maria Pichler, Elga Bataraga, Mario Puviani, Klaus Eisendle JDDG: Journal der Deutschen Dermatologischen Gesellschaft.2025; 23(5): 621. CrossRef
Mammary Paget’s Disease of the Nipple: A Case Report Loubna Slama, Hafsa Taheri, Nadir Miry, Amal Bennani, Zainab Chatbi, Ibtissam Bellajdel, Hanane Saadi, Ahmed Mimouni Case Reports in Oncology.2025; 18(1): 780. CrossRef
Paget's disease of the breast: Presentation, treatment, and outcomes in a modern cohort Dorsa Mousa-Doust, Rebecca Warburton, Jin-Si Pao, Carol Dingee, Amy Bazzarelli, Jieun Newman-Bremang, Elaine McKevitt The American Journal of Surgery.2024; 231: 18. CrossRef
A revised modified LICAP flap as a novel oncoplastic breast-conserving surgery technique for Mammary Paget’s disease Timothy Nario, Joseph Do Woong Choi, Sara Wu, Thomas Oh, Jeremy Hsu Surgery Case Reports.2024; 2: 100020. CrossRef
Mammary Paget's Disease Mimicking Benign and Malignant Dermatological Conditions: Clinical Challenges and Diagnostic Considerations Renee Scott-Emuakpor, Setareh Reza-Soltani, Sana Altaf, Kaushik NR, Faustyna Kołodziej, Susana Sil-Zavaleta, Monica Nalla, Muhammad Naqib Ullah, Maha R Qureshi, Yasmin Ahmadi, Ali Rezvani, Humza F Siddiqui Cureus.2024;[Epub] CrossRef
An Overview of Clinical Manifestations of Dermatological Disorders in Intensive Care Units: What Should Intensivists Be Aware of? Ali Al Bshabshe, Wesam F. Mousa, Nashwa Nor El-Dein Diagnostics.2023; 13(7): 1290. CrossRef
Mammary Paget’s Disease of Young Females: Case Reports and Comparison With Middle-Aged and Elderly Patients Chun-yan Lv, Xian-kui Cheng, Zhong-Yue Guo, Li Liu, Jian Cai, Tao Lei, Yan Tang Clinical Pathology.2023;[Epub] CrossRef
Descripción de un caso de adenomatosis erosiva del pezón: tratamiento quirúrgico Marcelo Chávez Díaz, Gonzalo Ziegler Rodríguez, Jaime Montes Gil Revista de Senología y Patología Mamaria.2023; 36(4): 100526. CrossRef
Mammary Paget’s Disease: An Update Sione Markarian, Dennis R. Holmes Cancers.2022; 14(10): 2422. CrossRef
An unusual case of longstanding mammary Paget disease presenting with reticulated skin changes S. K. Dhariwal, E. Rytina, J. C. Sterling Clinical and Experimental Dermatology.2021; 46(4): 748. CrossRef
Erosive Adenomatosis of the Nipple: A Clinical Diagnostic Challenge
Shuni Ying, Hong Fang, Jianjun Qiao Clinical, Cosmetic and Investigational Dermatology.2020; Volume 13: 587. CrossRef
Anxiety disorders are the most prevalent psychiatric disorders in the general population. The relationship between dyspepsia and particularly gastroesophageal reflux disease (GERD) and psychiatric comorbidity such as anxiety is poorly defined. However, GERD was noted to be strongly associated and often coincident in onset with generalized anxiety disorder in the community. In this paper, we report the case of an adult man who presented with severe weight loss and underlying GERD, and was later found to have an anxiety disorder as the cause of both.
Hemiballismus, a subtype of chorea, is a rare movement disorder, and is most commonly found secondary to stroke. Movements are involuntary, violent, coarse, and have a wide amplitude. There is increasing report of hemiballismus occurring in non-ketotic hyperglycemia. Spontaneous improvements or remissions were observed in many patients, and treatment should be directed towards the cause of hemiballismus. There is no randomized control trial to guide clinicians in deciding the best treatment option when managing hemiballismus. Symptomatic treatment includes the use of drugs such as dopamine receptor blocker and tetrabenazine. Surgical treatment is reserved for severe, persistent, and disabling hemiballismus. This case is of an elderly woman with long standing uncontrolled diabetes who presented with abnormal movement in her left upper limb for 2 months, which resolved slowly with good control of her glucose levels. Treating physicians need to have a high index of suspicion to prevent mismanagement of the condition.
Citations
Citations to this article as recorded by
Hemichorea in patients with temporal lobe infarcts: Two case reports Xu-Dong Wang, Xing Li, Chun-Lian Pan World Journal of Clinical Cases.2024; 12(4): 806. CrossRef
Bilateral Chorea-Ballism Associated With Non-ketotic Hyperglycemia: A Case Report Ouafae Abbassi, Amina Ali Kako, Yassine Mebrouk Cureus.2024;[Epub] CrossRef
Non-ketotic hyperglycaemic hemichorea-hemiballismus with Fahr’s disease in a Chinese family: a case report Si-Huan Zhu, Jin-Jin Peng, Ke-Fan Li, Jian-Cheng Peng, Jun Li International Journal of Neuroscience.2023; 133(11): 1242. CrossRef
Atypical Imaging Findings of Nonketotic Hyperglycemic Hemichorea: A Case Report and Review of the Literature Christopher M Stevens, Kevin Malone, Arielle Degueure, Amro Saad Aldine, Octavio Arevalo Cureus.2023;[Epub] CrossRef
Hemiballism and chorea with acute/subacute onset: a retrospective series Yeşim Güzey Aras, Sena Boncuk Ulaş, Türkan Acar, Bilgehan Atılgan Acar Acta Neurologica Belgica.2023; 123(2): 591. CrossRef
Bilateral striatum with high-signal intensity on T1-weighted MRI: A case of hemichorea induced by nonketotic hyperglycemia Yuanyi Pan, Fattyang Chew, Rongping Wang, Xuntao Yin, Yaying Li Radiology Case Reports.2021; 16(4): 895. CrossRef
Haemichorea–haemiballism associated with poorly controlled type 2 diabetes mellitus (a video demonstration) Shun Yamashita, Masaki Tago, Shu-ichi Yamashita BMJ Case Reports.2021; 14(4): e242949. CrossRef
La striatopathie diabétique : une complication rare et traitable du diabète sucré N. Gouta, S. Younes, B. Hidouri, H. Bouguila, F. Boubaker NPG Neurologie - Psychiatrie - Gériatrie.2021; 21(126): 424. CrossRef
Diabetes and neurology: hemichorea–hemiballism in hyperglycaemia Kim Yen Galloway, Osman Younus, Graziella Quattrocchi, Bazo Raheem, George Dervenoulas, Eli Silber Clinical Medicine.2020; 20(2): s21. CrossRef
Hemiballismus in subcortical lacunar infarcts ChinyeluUchenna Ufoaroh, OvercomerNnaemeka Agah, Nnamdi Morah, ErnestNdukaife Anyabolu Nigerian Journal of Medicine.2020; 29(3): 527. CrossRef
Hemiballismus Presenting as a Metabolic
Debipriya Saha, Kanak Choudhury Bengal Physician Journal.2020; 6(3): 74. CrossRef
Corea secundaria a hiperglucemia no cetósica: a propósito de un caso E. Esteban-Zubero, R. Castejón-Moreno, C. García-Muro, M.A. Alatorre-Jiménez, A. Marín-Medina Medicina de Familia. SEMERGEN.2019; 45(8): 569. CrossRef
Investigation of the relationship between non-ketotic hyperglycemia and hemichorea-hemiballism Po-Jen Hsiao, Chih-Chun Kuo, Tai-You Kuo, Yung-Hsi Kao, Jenq-Shyong Chan, Yen-Yue Lin, Ming-Hua Chen, Jin-Shuen Chen, Chih-Pin Chuu Medicine.2019; 98(28): e16255. CrossRef
First
Prev
