Ectopic ACTH Syndrome – Experience with Etomidate
Keywords:
etomidate, ectopic ACTH syndrome, Cushing’s syndromeAbstract
For ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS), when surgery is not feasible, or in cases of severe biochemical disturbances, immunosuppression or mental instability, medical therapy with agents such as etomidate is indicated. We present our experience in using etomidate for a 41-year old female with EAS secondary to a malignant mediastinal paraganglioma. We were able to demonstrate that etomidate can be used effectively to control severe hypercortisolism in a lower dose than previously described.
Downloads
References
Brown WH. A case of pluriglandular syndrome: Diabetes of bearded women. Lancet. 1928;2:1022-3.
Salgado LR, Fragoso MCB, Knoepfelmacher M et al. Ectopic ACTH syndrome: Our experience with 25 cases. Eur J Endocrinol. 2006;155(5):725-33. https://doi.org/10.1530/eje.1.02278.
Stewart PM, Walker BR, Holder G, O’Halloran D, Shackleton CH. 11-beta hydroxysteroid dehydrogenase activity in Cushing’s syndrome: Explaining the mineralocorticoid excess state of ectopic ACTH syndrome. J Clin Endocrinol Metab. 1995;80(12):3617-20. https://doi.org/10.1210/jcem.80.12.8530609.
Wald O, Shapira OM, Murar A, Izhar U. Paraganglioma of the mediastinum: Challenges in diagnosis and surgical management. J Cardiothorac Surg. 2010;5:19. https://doi.org/10.1186/1749-8090-5-19.
Biller BM, Grossman AB, Stewart PM et al. Treatment of adrenocorticotropin-dependent Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab. 2008;93(7):2454-62. PMID: 1841327. PMCID: PMC3214276. https://doi.org/10.1210/jc.2007-2734.
Preda VA, Sen J, Karavitaki N, Grossman AB. Etomidate in the management of hypercortisolaemia in Cushing’s syndrome: A review. Eur J Endocrinol. 2012;167(2):137-43. https://doi.org/10.1530/EJE-12-0274.
Schulte HM, Benker G, Reinwein D, Sippell WG, Allolio B. Infusion of low dose etomidate: Correction of hypercortisolemia in patients with Cushing’s syndrome and dose-response relationship in normal subjects. J Clin Endocrinol Metab. 1990;70(5):1426-30. https://doi.org/10.1210/jcem-70-5-1426.
Published
How to Cite
Issue
Section
License
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to jafes@asia.com or jafes.editor@gmail.com.
A written agreement shall be emailed to the requester should permission be granted.
