A Case of Parathyroid Adenoma in a Patient with Iatrogenic Cushing Syndrome |
의인성 쿠싱 증후군으로 의심된 환자에서 발견된
부갑상선 선종 1예
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김정권,김문규,심명숙,신영구,정춘희* |
연세대학교 원주의과대학 내분비내과 |
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Abstract |
There are numerous causes of secondary bone loss, including adverse effects of drug therapy, endocrine disorders, eating disorders, immobilization, disorders of the gastrointestinal or biliary tract, renal disease, and cancer.
Glucocorticoid hormones have revolutionized the management of many illnesses, reducing morbidity in conditions such as rheumatoid arthritis and mortality in other diseases. However, they have many side effects. Prolonged corticosteroid therapy increases the risk of osteoporosis and fracture.
A 63-year-old woman was admitted to the hospital because of severe arthralgia and bone pain. The patient was diagnosed as degenerative arthritis 10 years ago, and took corticosteroid for several years. But symptom was not improved.
It was sufficient for us to diagnose her as iatrogenic Cushing syndrome because she showed puffy face and paper-like skin. Radiographs of the hands and lumbar spine showed increased bone radiolucency. The bone mineral density of the lumbar spine and femoral neck was measured and the T-score on second lumbar spine was -3.91. We thought that the cause of osteoporosis might be iatrogenic Cushing syndrome combined with hormonal deficiency. But on physical examination, there was a 0.5×1 cm sized palpable cervical mass. On laboratory test and imaging study, this mass was suspected as a parathyroid mass. She was taken a operation and the pathologic diagnosis of the mass was parathyroid adenoma.
We report a case of parathyroid adenoma induced osteoporosis combined with iatrogenic Cushing syndrome in 63 year old female.
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Key Words:
Osteoporosis, Parathyroid adenoma, Iatrogenic cushing syndrome |
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