A case of systemic lupus erythematosus in which Cushing's syndrome caused by adrenal adenoma accidentally occurred during long-term maintenance therapy with corticosteroids

Mod Rheumatol Case Rep. 2020 Jan;4(1):34-38. doi: 10.1080/24725625.2019.1651488. Epub 2019 Aug 20.

Abstract

A 30-year-old female patient had been administered 5-mg/day prednisolone for systemic lupus erythematosus. She developed hypertension, dyslipidemia, moon face, central obesity, hypertrichosis, and impaired glucose tolerance. Although iatrogenic Cushing syndrome was initially suspected, we made a diagnosis of Cushing syndrome caused by a right adrenal adenoma, on the basis of the endocrine function test result and imaging findings. After surgery, the Cushingoid signs disappeared. Autoimmune diseases are often treated with corticosteroids; therefore, a differential diagnosis of primary Cushing syndrome should be made adequately.

Keywords: Cushing syndrome; Systemic lupus erythematosus; adrenal adenoma; corticosteroids.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects*
  • Adrenocortical Adenoma / complications*
  • Adrenocortical Adenoma / diagnosis
  • Adrenocortical Adenoma / surgery
  • Adult
  • Cushing Syndrome / diagnosis*
  • Cushing Syndrome / etiology*
  • Cushing Syndrome / therapy
  • Diagnosis, Differential
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy
  • Prednisolone / administration & dosage
  • Prednisolone / adverse effects
  • Symptom Assessment
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Prednisolone