Rare cause of Cushing\u27s syndrom

Cushingov sindrom je skupek kliničnih znakov in simptomov, ki so posledica povišanih količin glukokortikoidov v telesu. Delimo ga lahko v dve veliki skupini: prvo, kjer visoke vrednostikortikotropina vzpodbudijo skorjo nadledvične žleze k povečani tvorbi glukokortikoidov (od kortikotropina odvisni Cushingov sindrom), in drugo, kjer je Cushingov sindrom posledica povečanega izločanja glukokortikoidov iz bolezensko spremenjene nadledvične žleze (od kortikotropina neodvisni Cushingov sindrom). Redek vzrok Cushingovega sindroma je ektopični tumor, ki povečano izloča kortikotropin. V klinični sliki ektopičnega Cushingovega sindroma prevladuje povišan krvni tlak, edemi, hipokalijemija in intoleranca za glukozo. Najpogosteje je povezan z drobnoceličnim karcinomom pljuč, redkeje s karcinoidi, tumorji trebušne slinavke, tumorji timusa ali medularnimi karcinomi ščitnice. Zdravljenje ektopičnega Cushingovega sindroma je, dokler ne odkrijemo vzroka, simptomatsko, ko je vzrok znan, pa vzorčno.Cushing\u27s syndrome is the term used to describe clinical symptoms and signs related to an increased concentration of glucocorticoids in the body. Cushing\u27s syndrome can be divided into two categories: corticotropin-dependent Cushing\u27s syndrome, in which abnormally high plasma corticotropin levels stimulate the adrenal cortex to produce excessive amounts of glucocorticoids, and corticotropin-independent Cushing\u27s syndrome, in which excessive production of glucocortioids is due to abnormal adrenocortical tissue. In rare cases, the cause of Cushing\u27s syndrome may be an ectopic tumor which secretes corticotropin. The main clinical symptoms of ectopic Cushing\u27s syndrome include high blood pressure, edema, hypokalemia and glucose intolerance. Ectopic corticotropin production is most commonly found in pulmonary small cell carcinoma and rarely in carcinoid tumors, islet cell carcinoma of the pancreas, thymoma and medullary thyroid carcinoma. Treatment of ectopic Cushing\u27s syndrome is initially symptomaticwhen the cause of the syndrome has been established, it can be etiologic