Cushing's Disease Misdiagnosed as Primary Aldosteronism：A Case Report and Literature Review
GUO Xiao-dan
WANG Ning
ZHAO Zhen-zhen
CHEN Huan
CUI Wei
Abstract：Objective To strengthen the understanding of atypical Cushing syndrome manifestations in Cushing dis-ease in order to improve the early diagnosis, reduce misdiagnosis or missed diagnosis and the mortality rates. Methods Clin-ical data of one patient with Cushing disease,who was admitted to our hospital in 2013 and misdiagnosed as having primary al-dosteronism, was retrospectively analyzed,and the related literature was reviewed. Results This patient with atypical Cushing syndrome manifestations, who suffered from hypertension and severe low blood potassium, was misdiagnosed as having primary aldosteronism. However the symptom did not improve after oral spironolactone and potassium. After inhibition test of small dose and large dose of dexamethasone, dynamic contrast-enhanced MRI appearances of pituitary, testing adrenocortical hor-mone(ACTH) by bilateral inferior petrosal sinus sampling ( BIPSS) in our hospital, this patient was diagnosed as having Cushing's disease. The levels of electrolyte, cortisol and ACTH returned to normal after left pituitary micro-adenoma enuclea-tion operation. Conclusion Clinicians should pay close attention to identifying atypical Cushing syndrome manifestations in Cushing disease patients who suffer from hypertension and severe low blood potassium and need to do relevant medical exami-nations in order to make early diagnosis and have early treatment, which will help to improve the prognosis of these patients.
Keywords：Cushing's diseaseDiagnostic errorHyperaldosteronismPetrosal sinusAdrenocorticotropic hormone
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 26-29 )