Iatrogenic Cushing's syndrome and steroid hepatopathy in a cat

1999 ◽  
Vol 35 (1) ◽  
pp. 48-51 ◽  
Author(s):  
M Schaer ◽  
PE Ginn
Keyword(s):  
Diabetes Mellitus ◽  
Cushing’S Syndrome ◽  
Liver Enzymes ◽  
Periodic Acid ◽  
Cushing's Syndrome ◽  
Periodic Acid Schiff ◽  
Glycogen Accumulation ◽  
Elevated Liver Enzymes ◽  
High Incidence ◽  
Iatrogenic Cushing’S Syndrome

The distinguishing clinical features of Cushing's syndrome in the cat include very friable skin, a high incidence of diabetes mellitus, and the general absence of steroid hepatopathy. This case report describes a nine-year-old, spayed female domestic shorthair with triamcinolone-induced Cushing's syndrome. Unique to this cat were markedly elevated liver enzymes which prompted an expanded clinical evaluation. An ultrasonographic-guided liver biopsy demonstrated diffuse hepatocellular vacuolation that stained periodic acid-Schiff (PAS) positive and was removed subsequently with diastase application, indicating glycogen accumulation. These findings are compatible with the rarely seen syndrome of steroid hepatopathy in the cat.

scholarly journals Favorable outcome of pheochromocytoma in a dog with atypical Cushing’s syndrome and diabetes mellitus following medical treatment: a case report

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Ga-Won Lee ◽  
Cho-Rong Yoo ◽  
Dan Lee ◽  
Hee-Myung Park
Keyword(s):  
Case Report ◽  
Cushing’S Syndrome ◽  
Adrenal Mass ◽  
Liver Enzymes ◽  
Glycosylated Hemoglobin ◽  
Vena Cava ◽  
Clinical Signs ◽  
Cushing's Syndrome ◽  
Elevated Liver Enzymes

Abstract Background Pheochromocytoma (PCC) has poor prognosis and adrenalectomy is hard to be performed, in case of caudal vena cava invasion. The long-term administration of phenoxybenzamine in PCC has not been reported in dogs. Case presentation A 14-year-old castrated male Poodle dog presented with an abdominal mass. On physical examination, hypertension, increased lens opacity, calcinosis cutis, generalized alopecia, and systolic murmur were observed. Serum chemistry and urinalysis profiles revealed hyperglycemia, hypercholesterolemia, elevated liver enzymes, and glucosuria. Abdominal ultrasonography showed a right adrenal mass with invasion of the caudal vena cava, which was cytologically diagnosed as suspected PCC. An adrenal mass (width × height × length, 28 × 26 × 48 mm3) was found on computed tomography and diagnosed as PCC with increased plasma metanephrines and normetanephrines. An adrenocorticotropin hormone stimulation test showed elevated adrenal hormones (androstenedione, estradiol, progesterone, and 17-OH progesterone) with normal cortisol, compatible with atypical Cushing’s syndrome. The dog was managed with trilostane, phenoxybenzamine, and insulin therapy. Glycosylated hemoglobin and fructosamine levels gradually decreased, and hypertension resolved. In the 10-month follow-up period, the liver enzymes levels gradually decreased, and the clinical signs of the dog were well-controlled without deterioration. Conclusions This case report describes long-term medical management without adrenalectomy of PCC complicated with atypical Cushing’s syndrome and DM.

Secondary diabetes mellitus in patients with endogenous cushing's syndrome

2018 ◽  
Author(s):  
Cristina Capatina ◽  
Ionela Baciu ◽  
Daniela Greere ◽  
Andra Caragheorgheopol ◽  
Catalina Poiana
Keyword(s):  
Diabetes Mellitus ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Secondary Diabetes ◽  
Secondary Diabetes Mellitus

scholarly journals Candida Chorioamnionitis in Mothers with Gestational Diabetes Mellitus: A Report of Two Cases

2021 ◽  
Vol 18 (14) ◽  
pp. 7450
Author(s):  
Elia Shazniza Shaaya ◽  
Siti Atiqah Abdul Halim ◽  
Ka Wen Leong ◽  
Kevin Boon Ping Ku ◽  
Pei Shan Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Umbilical Cord ◽  
Neonatal Death ◽  
Periodic Acid ◽  
Careful Examination ◽  
Periodic Acid Schiff ◽  
History Of ◽  
Methenamine Silver

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid– Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.

scholarly journals Secondary Diabetes Mellitus in Patients with Endogenous Cushing’s Syndrome - Clinical Characteristics at Diagnosis

2018 ◽  
Vol 25 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Cristina Căpăţînă ◽  
Ionela Baciu ◽  
Daniela Greere ◽  
Andra Caragheorgheopol ◽  
Cătălina Poiană
Keyword(s):  
Diabetes Mellitus ◽  
Arterial Hypertension ◽  
Cushing’S Syndrome ◽  
Central Obesity ◽  
Clinical Characteristics ◽  
Clinical Signs ◽  
Cushing's Syndrome ◽  
Secondary Diabetes ◽  
Secondary Diabetes Mellitus ◽  
Proximal Myopathy

Abstract Background and aims. Endogenous Cushing’s syndrome is a rare disease associated with severe morbidity and increased mortality if untreated. Diabetes mellitus is a frequent initial complaint of these patients. Our aim was to investigate the clinical characteristics at the time of diagnosis in a cohort of patients with endogenous Cushing’s syndrome (CS). Material and methods. A retrospective analysis of the presentation of 68 cases diagnosed with endogenous Cushing’s syndrome followed-up in our institution was performed. Results: There were 57 women and 11 men, aged 18-74 years (mean 45.57±14.2). 38 had Cushing’s disease (CD) while 30 had adrenal CS. The most frequent signs/symptoms leading to the initial consultation and diagnostic suspicion were central obesity (55 cases, 80.88%), purple striae (28 cases, 41.1%), secondary arterial hypertension (27 cases, 39.7%), secondary diabetes mellitus (24 cases, 35.29%), hirsutism in 23/55 women (41.81%), hypogonadism in 23 cases (33.82%), proximal myopathy in 17 cases (25%), edema (10 cases, 14.7%). 13 cases (19.11%) also had secondary osteoporosis (diagnosed by dual energy x-ray absorptiometry - DXA osteodensitometry). Among the two diagnostic groups there were several differences. Proximal myopathy, secondary hypertension and diabetes mellitus were all more frequent in cases with adrenal Cushing compared to those with CD. (p= 0.011, 0.006 and 0.024, respectively). This did not reflect more severe hypercortisolism in adrenal CS, as the hormonal values were similar in the two groups. Conclusion: If associated with certain clinical signs, some nonspecific (central obesity, edema, arterial hypertension), other more suggestive of CS (purple striae, proximal myopathy) diabetes mellitus could be the initial sign of this severe condition.

scholarly journals Frequency of Osteoporosis in Iatrogenic Cushing’s syndrome: Scenario of outpatient department in urban hospitals

2020 ◽  
Vol 31 (1) ◽  
pp. 18-21
Author(s):  
Tamanna Bahar ◽  
Shaila Rahman ◽  
Lilian Catherene Gomes ◽  
Mohammad Murad Hossain ◽  
Zulfia Zinat Chowdhury ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing Syndrome ◽  
Reference Population ◽  
Final Diagnosis ◽  
Cushing's Syndrome ◽  
Outpatient Department ◽  
Clinical Feature ◽  
Cross Sectional ◽  
Prevalence Of Osteoporosis ◽  
Iatrogenic Cushing’S Syndrome

Background: Cushing’s syndrome is caused by excessive activation of glucocorticoid receptor. Iatrogenic Cushing syndrome is the prevalent one world -wide .Patients with Cushing’s syndrome has a high prevalence of osteoporosis. Objective: To see the prevalence of osteoporosis in Iatrogenic Cushing’s syndrome patient. Method: This descriptive cross-sectional study included 211 diagnosed case of Cushing’s syndrome during the time period of December 2013 to December 2018 in outpatient department of Dhaka Medical College and Health and Hope Hospital. Final diagnosis was done on the basis of clinical feature, serum basal cortical level and BMD. We found male were prevalent one (56%).80.56% showed biochemical evidence of Cushing’s syndrome. BMD was done in 113 patients compared with a reference population by means of T score, 17.69% patient in osteoporotic range. Conclusion: The prevalence of osteoporosis and osteopenia is age and sex independent. Judicial use of steroid and co administration with calcium, bisphosphonate can prevent osteoporosis. Treatment with bisphosphonates should be considered in all patients (irrespective of age) with Cushing’s syndrome with a low BMD to reduce fracture. Bangladesh J Medicine Jan 2020; 31(1) : 18-21

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