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Considerations in Diagnosis of Cushing Syndrome
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We read the article by Boscaro et al1
with keen interest. Given the fact that Cushing syndrome remains a clinical
entity for which many people are screened simply because of uncertainty arising
from unusual presentations and limitations of current diagnostic tests, we
wish to extend the list of atypical presentations provided in this elegant
review.
In a recently published brief report, Lacroix et al2
reported an unusual case of 63-year-old woman who developed Cushing syndrome
as the result of expression of aberrant adrenocortical receptors responsive
to luteinizing hormone, chorionic gonadotropin (with its leuteinizing hormonelike
activity), and drugs activating serotonin (5-hydroxytryptamine) receptors
(cisapride, metoclopramide). The patient had macronodular adrenal hyperplasia.
Long-term treatment with leuprolide acetate led to complete reversal of the
syndrome.
There is now an abundance of evidence supporting the role of aberrant
or illicit receptors in the possible initiation and/or perpetuation of Cushing
syndrome.3 A few years prior to . . . [Full Text of this Article]
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