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Войти в исследования Zhonghua nei ke za zhi · 2010
[The clinical features of ectopic ACTH syndrome: a report of 16 cases].
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Yang Yan, Li Chun-lin, Mu Yi-ming, Tian Hui, Lu Ju-ming, Pan Chang-yu
Аннотация
OBJECTIVES: To improve the diagnostic and therapeutic ability of ectopic ACTH syndrome by analysing its clinical features.
METHODS: Sixteen cases of ectopic ACTH syndrome diagnosed in Chinese PLA General Hospital from 2000 to 2009 were analyzed retrospectively.
RESULTS: (1) The main causes of ectopic ACTH syndrome were lung tumor and thymic carcinoid; (2) Abnormal glucose metabolism, hypertension, hypokalemia and edema of both lower limbs were the most common clinical symptoms; (3) Laboratory examination showed a significant increase of serum cortisol, adrenocorticotropic hormone (ACTH) and 24 h urinary free cortisol (24hUFC) together with severe hypokalemia and alkalosis; (4) High dose dexamethasone suppressing test, corticotrophin-releasing hormone (CRH) stimulating test and petrosal sinus sampling were the most meaningful diagnostic methods; (5) Most of the primary lesions might be detected with chest film and CT; (6) Resection of the primary lesion was the treatment of first choice.
CONCLUSION: The diagnosis of ectopic ACTH syndrome is very hard. Resection of the primary lesion is the best treatment.
METHODS: Sixteen cases of ectopic ACTH syndrome diagnosed in Chinese PLA General Hospital from 2000 to 2009 were analyzed retrospectively.
RESULTS: (1) The main causes of ectopic ACTH syndrome were lung tumor and thymic carcinoid; (2) Abnormal glucose metabolism, hypertension, hypokalemia and edema of both lower limbs were the most common clinical symptoms; (3) Laboratory examination showed a significant increase of serum cortisol, adrenocorticotropic hormone (ACTH) and 24 h urinary free cortisol (24hUFC) together with severe hypokalemia and alkalosis; (4) High dose dexamethasone suppressing test, corticotrophin-releasing hormone (CRH) stimulating test and petrosal sinus sampling were the most meaningful diagnostic methods; (5) Most of the primary lesions might be detected with chest film and CT; (6) Resection of the primary lesion was the treatment of first choice.
CONCLUSION: The diagnosis of ectopic ACTH syndrome is very hard. Resection of the primary lesion is the best treatment.