CushieBlog

Cushing syndrome is a prevalent endocrine disorder that impacts multiple bodily systems. Although 80% of patients have ACTH-dependent Cushing syndrome (typically caused by Cushing disease), around 20% of ACTH-independent CS are noted mostly due to adrenal adenoma. Patients with this condition have an approximately 8% risk of thromboembolism. This hypercoagulable state is thought to result from the activation of the coagulation cascade, along with impaired fibrinolysis and prolonged clot lysis time. Vigilance in recognizing and managing these complications is essential to improving patient outcomes.

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Case Report

A 44-year-old woman with a medical history of type 2 diabetes mellitus, obesity, and tobacco dependence presented to the clinic for obesity management. She had been started on weight loss medication, but there was minimal improvement in her condition. The patient denied using steroids or oral contraceptive pills and reported well-controlled diabetes. Due to the lack of progress, an extensive workup was conducted, revealing the following: an am cortisol of 2.4 mcg/dL after 1 mg of dexamethasone

Case Report

Few days later, she was admitted to the emergency department with acute hypoxia, requiring up to 6 L of oxygen via nasal cannula, and severe abdominal pain. A CT scan of the chest, abdomen, and pelvis revealed a right renal infarct, a splenic infarct, and a pulmonary embolism. A venous duplex of the left lower extremity was negative for deep vein thrombosis, and hypercoagulable workup was also negative. An echocardiogram identified a patent foramen ovale, which was repaired, and she was started

Discussion

This case highlights the necessity of providers to be aware of potential complications of endocrinological disorders. The risk of thromboembolism is more commonly present in patients with Cushing syndrome, who have risk factors such as obesity, surgery and invasive diagnostic procedures. Patients should be treated as having a prothrombotic disorder and undergo antithrombotic prophylaxis following procedures. The risk of thromboembolism in patients with Cushing syndrome should be widely

Conclusion

This case highlights the necessity of providers to be aware of potential complications of endocrinological disorders. The risk of thromboembolism is more commonly present in patients with Cushing syndrome, who have risk factors such as obesity, surgery and invasive diagnostic procedures. Patients should be treated as having a prothrombotic disorder and undergo antithrombotic prophylaxis following procedures. The risk of thromboembolism in patients with Cushing syndrome should be widely

Read the whole article here: https://www.sciencedirect.com/science/article/abs/pii/S1530891X25003945