© 2004 Fellowship of Postgraduate Medicine
SELF ASSESSMENT ANSWER
A young man with weight loss and depression
| The first 150 words of the full text of this article appear below. |
The clinical diagnosis is Cushing’s syndrome. The presence of thin atrophic skin, facial plethora, hyperpigmentation over the knuckles, proximal myopathy, hypokalaemia, psychiatric symptoms, hypertension, and diabetes mellitus led to the diagnosis of Cushing’s syndrome in this patient.
The basal cortisol levels were raised with loss of diurnal rhythm (am: 1200 nmol/l, pm: 1200 nmol/l). The diagnosis of Cushing’s syndrome was confirmed by non-suppressible serum cortisol (1200 nmol/l) with low dose dexamethasone challenge (0.5 mg every six hours for 48 hours). High evening cortisol with very inappropriately raised plasma adrenocorticotrophin (ACTH) levels (79 pmol/l) and non-suppressible serum cortisol (1200 nmol/l) with high dose dexamethasone challenge (2 mg every six hours for 48 hours) raised the possibility of an ectopic source of ACTH. Magnetic resonance imaging of the sella was done and was normal. Subsequently computed tomography of the chest and abdomen were performed. Computed tomography of the chest revealed an anterior
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Relevant Article
- A young man with weight loss and depression
- P Velayutham, A Bhansali, M Shriraam, S Thingnam, S Mathur
Postgrad. Med. J. 2004 80: 243.[Extract] [Full Text] [PDF]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
