A case of systemic lupus erythematosus complicated by subclinical Cushing's syndrome: case report

Mod Rheumatol Case Rep. 2020 Jan;4(1):16-20. doi: 10.1080/24725625.2019.1638049. Epub 2019 Jul 11.

Abstract

An 18-year-old female was diagnosed with subclinical Cushing's syndrome (CS) due to a left adrenal adenoma. When she was 20 years old, she developed lupus nephritis. She was treated with high-dose prednisolone (PSL) and soon developed the symptoms of CS. When she was 25 years old, we evaluated her serum glucocorticoid level while she continued to take oral PSL. The result suggested her CS was affected by both the oral PSL and the endogenous cortisol secreted by the adrenocortical adenoma, which was therefore resected. Seven months after the operation, the patient's body weight was decreasing, and her SLE remained in clinical remission. CS complicated by SLE is rare, and the decision to surgically remove an adrenal tumor in such a case is even more rare.

Keywords: Cushing’s syndrome; SLE; subclinical Cushing’s syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adrenocortical Adenoma / diagnosis
  • Adrenocortical Adenoma / etiology
  • Adrenocortical Adenoma / surgery
  • Clinical Decision-Making
  • Cushing Syndrome / complications*
  • Cushing Syndrome / diagnosis
  • Disease Management
  • Female
  • Glucocorticoids / blood
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Nephritis / diagnosis
  • Lupus Nephritis / drug therapy
  • Lupus Nephritis / etiology
  • Prednisolone / administration & dosage
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Prednisolone