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