[Association of Cushing syndrome and anti-phospholipid syndrome: about one case]

Cushing syndrome is a pro-thrombotic state that contributes to an increase in mortality. The antiphospholipid syndrome is characterized by repetitive thrombosis associated with the presence of autoantibodies against phospholipids or membrane proteins. Their association has not yet been described. We report the case of a 47 year old patient in whom the hormonal exploration of an adrenal incidentaloma led to the diagnosis of Cushing syndrome. He returned five years later with cerebral thrombophlebitis, bilateral lower limbs phlebitis and bilateral pulmonary emboli. An antiphospholipid syndrome was confirmed by positive anti-cardiolipin and anti-beta2 glycoproteine-I antibodies. The patient recovered after anti-coagulant treatment and resection of the adrenal adenoma. Thrombo-embolic complications during Cushing syndrome, especially when severe and extensive, must lead to the search for another acquired thrombotic condition, especially the antiphospholipid syndrome

[Osteoporosis endocrine origin]

Osteoporosis is the most widespread metabolic bone disease in the world. The secondary osteoporosis due to endocrinopathies must be known because of its frequency and of its improvement with the control of the etiological factor. The progress made in bone densitometry and in the biochemical markers of bone remodelling make possible a better study of the bone repercussion of the endocrinopathies. The mechanism of bone loss during endocrinopathies is an imbalance between formation and resorption. Osteoporosis is a frequent complication of type 1 diabetes, hyperthyroidism, hypercortisolism, primary hyperparathyroidism, hypogonadism and hyperprolactinemia. Data are controversial concerning the repercussion of the suppressive treatment of TSH during differentiated thyroid cancer and goiters. Treatment of endocrine osteoporosis is first preventive. The endocrine disorder should be corrected as early as possible. Bone density monitoring must be performed in patients presenting an endocrinopathy with a risk for osteoporosis