J Bone Metab.  2012 Nov;19(2):153-158. 10.11005/jbm.2012.19.2.153.

A Case of Cushing Syndrome Diagnosed by Recurrent Pathologic Fractures in a Young Woman

• Han JY
• Lee J
• Kim GE
• Yeo JY
• Kim SH
• Nam M
• Kim YS
• Hong S

• KMID: 1975990
• DOI: http://doi.org/10.11005/jbm.2012.19.2.153

Abstract

Cushing's syndrome is characterized by central obesity, fatigability, weakness, amenorrhea, hirsutism, edema, hypertension, impaired glucose tolerance, and osteoporosis due to excessive production of steroids. Cushing's syndrome is an important cause of secondary osteoporosis. Patients with Cushing's syndrome have a high incidence of osteoporotic fractures. At least, 30-50% of patients with Cushing's syndrome experience fractures, particularly in the vertebral body. And it is consistent with the 50% prevalence of osteoporosis in patients with Cushing's syndrome. However, reports of multiple pathological fractures in young patients with Cushing's syndrome are rare. Thus, we describe the case of a 26-year-old woman with Cushing's syndrome accompanied with recurrent multiple osteoporotic fractures and being treated by parathyroid hormone. Careful consideration for the possibility of Cushing's syndrome will be necessary in case of young patients with a spontaneous multiple compression fractures in spine.

Keyword

Cushing syndrome; Osteoporotic fractures

MeSH Terms

Adult
Amenorrhea
Cushing Syndrome
Edema
Female
Fractures, Compression
Fractures, Spontaneous
Glucose
Hirsutism
Humans
Hypertension
Incidence
Obesity, Abdominal
Osteoporosis
Osteoporotic Fractures
Parathyroid Hormone
Prevalence
Spine
Steroids
Glucose
Parathyroid Hormone
Steroids

Figure

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  Fig. 1 Thoraco-lumbar spine series showed compression fracture on 12th thoracic vertebra body.

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  Fig. 2 Bone mineral density of lumbar spine and femur neck showed below the expected range for age. BMD, bone mineral density

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  Fig. 3 Adrenal gland computed tomography showed 2.7 × 2.4 cm sized mass on left adrenal gland.

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