臨床医学ジャーナル

概要

Adrenocorticotropic Hormone (ACTH) Independent Cushing’s Syndrome Presenting as Hypertension in the Young: A Case Report from Kumasi, Ghana

Prince Yaw Boahene, Solomon Gyabaah, Prince Addo Ameyaw, Lisa Annabelle Agyei- Mensah

The endogenous cause of Cushing’s syndrome is very rare with an incidence of 0.7–2.4 per million population per year. Diagnosis of this syndrome may pose a challenge on the clinician for the fact that it is rare and also shares many features with the more common condition metabolic syndrome. We present the case of a 31 year old overweight male with no known chronic disease presenting with abdominal pain, moon face, striae, acne and hypertension. A post dexamethasone suppression cortisol level was >1750 nmol/l. The ACTH levels were 1 pg/ml which was below the lower limit of the reference range. An abdominal CT scan showed a well-defined enhancing mass arising from the lateral limb of the left adrenal gland measuring 2.6 × 2.1 cm with features consistent with an adrenal adenoma. Patient was treated with eplerenone, ketoconazole, hydralazine and losartan and he is currently doing well.