TYPE 2 DIABETES WITH RECURRENT OSTEOPOROTIC FRACTURES, OR CUSHING’S SYNDROME?

  • Blertina Dyrmishi Endocrinologist, department of Internal Medicine, Hygeia Hospital, Tirana, Albania
  • Taulant Olldashi Surgeon, Hygeia Hospital, Tirana, Albania
  • Prof Asc Thanas Fureraj Endocrinologist, UHC Mother Theresa, Tirana, Albania
  • Prof Asc Majlinda Ikonomi Pathologist, Hygeia Hospital, Tirana, Albania
  • Dorina Ylli Endocrinologist, UHC Mother Theresa, Tirana, Albania
  • Prof Agron Ylli Endocrinologist, Head of Endocrine Department, UHC “Mother Theresa”, Tirana, Albania
Keywords: Cushing’s syndrome, secondary osteoporosis, osteoporotic compressive fracture

Abstract

Aim: Presentation of a case with secondary osteoporosis and compressive fracture in Cushing’s syndrome.

Clinical Case: A 41 years old male was admitted to our hospital with inability to move the legs, severe back pain, which started 6 months ago. The patient was bedridden for a month due to severe pain. He was under treatment for hepatitis B and had been for more than three years under treatment for diabetes. One year ago he was treated for deep venous thrombosis.

Laboratory data: Loss of circadian rhythm of cortisol, increased free urinary cortisol level, lack of suppression of cortisol after 1 mg dexamethasone test. DXA: Osteoporosis. Spine x-Ray: recurrent osteoporotic compressive thoracic fracture. Abdominal MRI showed left adrenal nodular mass with dimensions 2.5 x 3.3 cm. The patient underwent surgery: Left adrenalectomy. 12 months after surgery the patient continuing the treatment with hydrocortisone, alendronate,
calcium and vitamin D, normal values of blood glucose and blood pressure without treatment and in DXA an improvement of the bone density was noticed.

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References

1. Larsen, Kronenberg, Melmed, Polonsky. Williams test book of endocrinology, 2003.pp 508-509.
2. Newell-Price J, Bertagna X, Grossman AB, Nieman LK. Cushing’s syndrome. Lancet 2006; 13(5); 367:1605-1617.
3. Nieman LK, Biller Mb, Findling JW et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guidelines. J Clin Endocrinol Metab 2008: 93(5): 1526-1540.
4. Colao A, Petersenn S, Newell –Price J, et al. Pasireotide B2305 Study Group. A 12 – month phase 3 study of pasireotide in Cushing’s disease. N Engl J Med 2012; 366 (10): 914-924
5. Ju Young Han, Jungjin Lee et al. A case of Cushing Syndrome Diagnosed by Recurent Pathologic Fractures in a Young Woman. J Bone metab. 2012. 19 (2): 153-158.
6. Arnaldi G, Angeli A, Atkinson AB, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab 2003; 88 (12): 5593-5602.
7. Pereira RM, Carvalho JF, Paula AP, and al. Guidelies for the prevention and treatment of glucocortikoid-induced osteoporosis. Rev Bras Reumatol 2012;52 (4): 580-593.
8. Rehman Q, Lang TF, Arnaud CD, et al. Daily treatment with parathyroid hormone is associate with an increase in vertebral cross-sectional area in postmenopausal women with glucocorticoid-induced osteoporosis. Int 2003; 14(1): 77-81.
9. Saag KG, Shane E, Boonen S, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007; 357: 2028-2039
How to Cite
1.
Blertina Dyrmishi, Taulant Olldashi, Prof Asc Thanas Fureraj, Prof Asc Majlinda Ikonomi, Dorina Ylli, Prof Agron Ylli. TYPE 2 DIABETES WITH RECURRENT OSTEOPOROTIC FRACTURES, OR CUSHING’S SYNDROME?. Med. res. chronicles [Internet]. 1 [cited 2024Nov.22];3(1):110-4. Available from: https://medrech.com/index.php/medrech/article/view/151
Issue
Vol. 3 No. 1 (2016): Jan-Feb
Section
Original Research Article

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