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Angelo Paci, Ségolène Hescot, Atmane Seck, Christel Jublanc, Lionel Mercier, Delphine Vezzosi, Delphine Drui, Marcus Quinkler, Martin Fassnacht, Eric Bruckert, Marc Lombès, Sophie Leboulleux, Sophie Broutin and Eric Baudin

Events v4 (NCI-CTCAE) criteria. At 3 months of mitotane therapy, an increase in LDL-cholesterol was found and resolved after the introduction of statins in September 2008. From 2008 onward, several triglyceride measurements were performed at the time of

Open access

Michelle Maher, Mohammed Faraz Rafey, Helena Griffin, Katie Cunningham and Francis M Finucane

. Investigation At initial assessment his HbA1c was 72 mmol/mol (8.7%), confirming poor glycaemic control. His lipid profile was excellent with a total cholesterol of 3.3, LDL 0.8, HDL 1.0 and triglycerides of 1.9 mmol/L. Liver profile and iron studies, as well

Open access

Athanasios Fountas, Zoe Giotaki, Evangelia Dounousi, George Liapis, Alexandra Bargiota, Agathocles Tsatsoulis and Stelios Tigas

Glucose (mg/dL) 79 70–100 Insulin (μIU/mL) 50.6 1.9–23 HbA1c (%) 5.5 4.3–5.6 HOMA-IR 9.87 Total cholesterol (mg/dL) 226 110–200 HDL cholesterol (mg/dL) 46 35–70 LDL cholesterol (mg/dL) 151 60

Open access

Satoru Sakihara, Kazunori Kageyama, Satoshi Yamagata, Ken Terui, Makoto Daimon and Toshihiro Suda

with cabergoline normalized plasma ACTH and cortisol levels for 1 year, but thereafter glucose, ACTH, and cortisol levels were once again increased. GH and prolactin levels were 0.11 and 5.2 ng/ml respectively. Fasting blood glucose, LDL cholesterol

Open access

Marcela Rodríguez Flores, Ruth Carmina Cruz Soto, Verónica Vázquez Velázquez, Reina Ruth Soriano Cortés, Carlos Aguilar Salinas and Eduardo García García

was 5.4%. Metabolic parameters were triglycerides 67 mg/dL, total cholesterol 182 mg/dL, HDL cholesterol 66 mg/dL, LDL cholesterol 103 mg/dL, folic acid 26.4 ng/mL, Vit B12 464 pg/mL, ferritin 10.1 ng/mL, vitamin D 45.1 ng/mL. She complained of

Open access

Ya-Wun Guo, Chii-Min Hwu, Justin Ging-Shing Won, Chia-Huei Chu and Liang-Yu Lin

, potassium; LDL-c: low-density lipoprotein cholesterol; Tg: triglyceride. Investigations Serial examinations for Cushing’s syndrome were then performed. The circadian rhythm of plasma cortisol disappeared (14.3 and 14.0μg/dL at 08:00h, and 14

Open access

Wann Jia Loh, Kesavan Sittampalam, Suan Cheng Tan and Manju Chandran

abnormalities nor were there any osmolar disturbances in the serum or urine. Total cholesterol, HDL, triglyceride and LDL levels were 3.29 mmol/l, 0.47 mmol/l, 1.47 mmol/l and 2.15 mmol/l respectively on a fasting lipid panel. A two-dimensional echocardiogram

Open access

Sebastian Hörber, Sarah Hudak, Martin Kächele, Dietrich Overkamp, Andreas Fritsche, Hans-Ulrich Häring, Andreas Peter and Martin Heni

kinase (mg/dL) Max. 170 43 239 161  Urea (mg/dL) 12–46 108 8  Total cholesterol (mg/dL) 130–190 239  Triglycerides (mg/dL) <200 111  LDL cholesterol

Open access

Anna Casteràs, Jürgen Kratzsch, Ángel Ferrández, Carles Zafón, Antonio Carrascosa and Jordi Mesa

. Diabetes was diagnosed based on a glycohemoglobin level of 6.8% with basal glucose levels of 128 mg/dl; hypercholesterolemia was also present: total cholesterol 247 mg/dl (<220), cLDL 182 mg/dl (<130), cHDL 32 mg/dl (>40), and triglycerides 166 mg/dl (43

Open access

M J Trott, G Farah, V J Stokes, L M Wang and A B Grossman

Summary

We present a case of a young female patient with a rare cause of relapsing and remitting Cushing’s syndrome due to ectopic ACTH secretion from a thymic neuroendocrine tumour. A 34-year-old female presented with a constellation of symptoms of Cushing’s syndrome, including facial swelling, muscle weakness and cognitive impairment. We use the terms ‘relapsing and remitting’ in this case report, given the unpredictable time course of symptoms, which led to a delay of 2 years before the correct diagnosis of hypercortisolaemia. Diagnostic workup confirmed ectopic ACTH secretion, and a thymic mass was seen on mediastinal imaging. The patient subsequently underwent thymectomy with complete resolution of her symptoms. Several case series have documented the association of Cushing’s syndrome with thymic neuroendocrine tumours (NETs), although to our knowledge there are a few published cases of patients with relapsing and remitting symptoms. This case is also notable for the absence of features of the MEN-1 syndrome, along with the female gender of our patient and her history of non-smoking.

Learning points

  • Ectopic corticotrophin (ACTH) secretion should always be considered in the diagnostic workup of young patients with Cushing’s syndrome
  • There is a small but growing body of literature describing the correlation between ectopic ACTH secretion and thymic neuroendocrine tumours (NETs)
  • The possibility of a MEN-1 syndrome should be considered in all patients with thymic NETs, and we note the observational association with male gender and cigarette smoking in this cohort
  • An exception to these associations is the finding of relatively high incidence of thymic NETs among female non-smoking MEN-1 patients in the Japanese compared with Western populations
  • The relapsing and remitting course of our patient’s symptoms is noteworthy, given the paucity of this finding among other published cases