Hyperglycemia and Hypokalemia in a 16-Year-Old Overweight Female Patient Misdiagnosed with Cushing Syndrome at First and Ultimately Diagnosed with Carney Complex Proven by PRKAR1A Gene Test: a Case Report and Literature Review

Clin Lab. 2019 Mar 1;65(3). doi: 10.7754/Clin.Lab.2018.180805.

Abstract

Background: Here we report on a 16-year-old female patient with typical Cushingoid features who was admitted because of purple striae, menostasis, and microsomia for 1 year, and laboratory tests showed hyperglycemia and hypokalemia.

Methods: For diagnosis, we employed a hormone test, abdominal and pituitary computed tomography scan, ultrasonography to detect endocrine and cardiocutaneous lesions. DNA sequencing to detect PRKAR1A gene mutation to make differential diagnosis for Cushing Syndrome.

Results: Hormone test revealed hypercortisolism, images demonstrated right adrenal nodular hyperplasia and hyperparathyroid hyperplasia. DNA sequencing analysis revealed a heterozygous C.680 G>A substitution in PRKAR1A.

Conclusions: We describe here an atypical Carney Complex (CNC) patient magnified Cushing Syndrome with a nonsense mutation in the PRKAR1A gene, which cannot sustain the diagnosis except for the RKAR1A gene sequencing for analysis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Carney Complex / blood
  • Carney Complex / diagnosis*
  • Carney Complex / genetics
  • Cushing Syndrome / diagnosis
  • Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / genetics*
  • Diagnosis, Differential
  • Female
  • Humans
  • Hyperglycemia
  • Hypokalemia
  • Overweight / complications

Substances

  • Cyclic AMP-Dependent Protein Kinase RIalpha Subunit
  • PRKAR1A protein, human