Sarcoidosis following Cushing's syndrome: A report of two cases and review of the literature

Exp Clin Endocrinol Diabetes. 2010 Mar;118(3):147-50. doi: 10.1055/s-0028-1087179. Epub 2010 Feb 16.

Abstract

Cushing's syndrome is characterized by excessive elevation of glucocorticoid concentrations. In rare cases, the treatment of Cushing's syndrome may result in unmasking or aggravation of diseases responsive to glucocorticoid medication. We report two cases of sarcoidosis following Cushing's syndrome. A 43 year-old male developed cutaneous sarcoidosis and mediastinal lymphadenopathy after resection of an ACTH-secreting pituitary microadenoma. A 32 year-old female showed cutaneous sarcoidosis, arthralgia, mediastinal lymphadenopathy and elevation of angiotensin-converting enzyme and interleukin 2-receptor concentrations after traumatic adrenal bleeding, which ceased formerly undiagnosed hypercortisolism caused by an adrenal adenoma. Sarcoidosis seems to be a rare sequel following the treatment of hypercortisolism. Skin affections were present and suggestive for the diagnosis in all reported cases. As some cases are probably missed when skin affections are lacking, a more frequent evaluation of patients after Cushing's syndrome for the possible diagnosis of sarcoidosis might be necessary.

Publication types

  • Case Reports
  • Review

MeSH terms

  • ACTH-Secreting Pituitary Adenoma / surgery*
  • Adenoma / surgery*
  • Adult
  • Arthralgia / diagnosis
  • Arthralgia / etiology
  • Cushing Syndrome / surgery*
  • Female
  • Humans
  • Lymphatic Diseases / diagnosis
  • Lymphatic Diseases / etiology
  • Male
  • Mediastinal Diseases / diagnosis
  • Mediastinal Diseases / etiology
  • Peptidyl-Dipeptidase A / analysis
  • Receptors, Interleukin-2 / analysis
  • Sarcoidosis / diagnosis
  • Sarcoidosis / etiology*
  • Skin Diseases / diagnosis
  • Skin Diseases / etiology*

Substances

  • Receptors, Interleukin-2
  • Peptidyl-Dipeptidase A