| Cushing Disease Diagnosed with Bilateral Simultaneous Inferior Petrosal Sinus Sampling. |
|
Seonmee Kim, Seung Hwan Lee, Hoi Hyun Chong, Woo Kyoung Lee, Myung Ho Hong |
|
Department of Family Medicine, College of Medicine, Korea University, Seoul, Korea. |
| 하추체 정맥동 채혈로 진단된 쿠싱병 |
|
김선미,이승환,정회현,이우경,홍명호 |
|
고려대학교 의과대학 가정의학교실 |
|
|
|
|
| Abstract |
|
The most common endogenous cause of Cushing's syndrome is Cushing's disease. The evaluation of patients with suspected Cushing's disease and syndrome requires an understanding of the proper use and limitations of the tests commonly included in the diagnostic work-up. The best screening test for Cushing's syndrome is a 24-hour urine collection with analysis for urinary free cortisol excretion. Low-dose and high-dose dexamethasone suppression tests, corticotropin assays, a corticotropin-release hormone stimulation test and inferior petrosal sinus cathaterization may be required for a definitive diagnosis. MRI is useful in localizing the lesion but some limitations. Surgical removal of the lesion by a trans-sphenoidal appraoch is usually successful, but long-term follow-up is required. We report a case of Cushing disease which shows such typical clinical characteristics of Cushing syndrome as weight gain, skin lesions, truncal obesity, striae, hypertension. |
| Key Words:
Cushing's syndrome, Cushing's disease |
| 초록 |
|
체중증가, 피부병변, 중심성 비만, 고혈압 등의 쿠싱증후군을 가진 쿠싱병 증례이다. 쿠싱증후군의 가장 흔한 내인성 원인은 쿠싱병이다. 쿠싱증후군에 관한 가장 좋은 선별검사는 24시간 소변을 모아 유리 코티졸의 농도를 재는 것이고, 저용량과 고용량의 덱사메타손 억제검사, cortisol과 ACTH의 농도 측정, CRH 자극 검사, IPSS 등이 쿠싱병을 확진하는데 이용되며 MRI는 병변위치를 알아보는 데 쓰이고 있지만 여러 제한점이 따른다. 일단 쿠싱병이라는 진단이 내려지면 trans-sphenoidal approach를 이용한 수술적 제거가 이용되며 술 후 장기간에 걸친 추적관찰이 요구된다. |
| 중심 단어:
쿠싱증후군, 쿠싱병 |
|
PDF Links
Full text via DOI
Download Citation
