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Successful management of a patient with active Cushing's disease complicated with coronavirus disease 2019 (COVID-19) pneumonia.
Yuno, Akiko; Kenmotsu, Yoshiyuki; Takahashi, Yuka; Nomoto, Hiroshi; Kameda, Hiraku; Cho, Kyu Yong; Nakamura, Akinobu; Yamashita, Yu; Nakamura, Junichi; Nakakubo, Sho; Kamada, Keisuke; Suzuki, Masaru; Sugino, Hirokazu; Inoshita, Naoko; Konno, Satoshi; Miyoshi, Hideaki; Atsumi, Tatsuya; Sawamura, Yutaka; Shimatsu, Akira.
  • Yuno A; Department of Internal Medicine, Kin-ikyo Chuo Hospital, Sapporo 007-8505, Japan.
  • Kenmotsu Y; Department of Internal Medicine, Kin-ikyo Chuo Hospital, Sapporo 007-8505, Japan.
  • Takahashi Y; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Nomoto H; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Kameda H; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Cho KY; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Nakamura A; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Yamashita Y; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Nakamura J; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Nakakubo S; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Kamada K; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Suzuki M; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Sugino H; Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Inoshita N; Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo 173-0015, Japan.
  • Konno S; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Miyoshi H; Division of Diabetes and Obesity, Faculty of Medicine and Graduate School of Medicine Hokkaido University, Sapporo 060-8648, Japan.
  • Atsumi T; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8648, Japan.
  • Sawamura Y; Sawamura Neurosurgery Clinic, Sapporo 060-0807, Japan.
  • Shimatsu A; Advanced Medical Care Center, Kusatsu General Hospital, Kusatsu 525-8585, Japan.
Endocr J ; 68(4): 477-484, 2021 Apr 28.
Article in English | MEDLINE | ID: covidwho-1204140
Semantic information from SemMedBD (by NLM)
1. Pituitary-dependent Cushing\'s disease PROCESS_OF Patients
Subject
Pituitary-dependent Cushing\'s disease
Predicate
PROCESS_OF
Object
Patients
2. Pituitary-dependent Cushing\'s disease COMPLICATES Pneumonia
Subject
Pituitary-dependent Cushing\'s disease
Predicate
COMPLICATES
Object
Pneumonia
3. Pituitary-dependent Cushing\'s disease COMPLICATES COVID-19
Subject
Pituitary-dependent Cushing\'s disease
Predicate
COMPLICATES
Object
COVID-19
4. Undiagnosed PROCESS_OF Patients
Subject
Undiagnosed
Predicate
PROCESS_OF
Object
Patients
5. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
6. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
7. Severe infection COEXISTS_WITH risk factors
Subject
Severe infection
Predicate
COEXISTS_WITH
Object
risk factors
8. Pituitary-dependent Cushing\'s disease CAUSES Adrenal Gland Hyperfunction
Subject
Pituitary-dependent Cushing\'s disease
Predicate
CAUSES
Object
Adrenal Gland Hyperfunction
9. Pituitary-dependent Cushing's disease PROCESS_OF Patients
Subject
Pituitary-dependent Cushing's disease
Predicate
PROCESS_OF
Object
Patients
10. Pituitary-dependent Cushing's disease COMPLICATES Pneumonia
Subject
Pituitary-dependent Cushing's disease
Predicate
COMPLICATES
Object
Pneumonia
11. Pituitary-dependent Cushing's disease COMPLICATES COVID-19
Subject
Pituitary-dependent Cushing's disease
Predicate
COMPLICATES
Object
COVID-19
12. Undiagnosed PROCESS_OF Patients
Subject
Undiagnosed
Predicate
PROCESS_OF
Object
Patients
13. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
15. Severe infection COEXISTS_WITH risk factors
Subject
Severe infection
Predicate
COEXISTS_WITH
Object
risk factors
16. Pituitary-dependent Cushing's disease CAUSES Adrenal Gland Hyperfunction
Subject
Pituitary-dependent Cushing's disease
Predicate
CAUSES
Object
Adrenal Gland Hyperfunction
ABSTRACT
We provide the details of the successful management of a patient with active Cushing's disease complicated with coronavirus disease 2019 (COVID-19) pneumonia. The patient was a 27-year-old Japanese female healthcare worker who was scheduled to undergo pituitary surgery for Cushing's disease. She had been in close contact with an undiagnosed patient infected with COVID-19 and then developed COVID-19 pneumonia. Despite a lack of known risk factors associated with severe COVID-19 infection, the patient's dyspnea worsened and her respiratory condition deteriorated, as indicated by the need for 7 L/min oxygen supply by mask to maintain her oxygen saturation at >90%. Medical treatment was initiated to control hypercortisolism by the 'block and replace' regimen using steroidogenesis inhibitors and hydrocortisone. The COVID-19 pneumonia improved with multi-modal treatment including antiviral therapy. One month later, after a negative severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) test result and with appropriate protection against virus transmission to medical staff in the operating room and daily medical care nurses, trans-sphenoidal surgery was performed by our highly experienced pituitary surgeon. One month after the surgery, the patient's basal ACTH and cortisol levels and urinary free cortisol were all under the detection limit. Surgical remission was expected. Since hypercortisolism due to active Cushing's disease may worsen a COVID-19 infection, multi-disciplinary management that includes appropriate and prompt treatment strategies is mandatory in such cases.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnenediones / Pyrazines / Benzamidines / Pituitary ACTH Hypersecretion / Amides / COVID-19 / Guanidines / Metyrapone Type of study: Risk factors Limits: Adult / Female / Humans Country/Region as subject: Asia Language: English Journal: Endocr J Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: Endocrj.ej20-0613

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnenediones / Pyrazines / Benzamidines / Pituitary ACTH Hypersecretion / Amides / COVID-19 / Guanidines / Metyrapone Type of study: Risk factors Limits: Adult / Female / Humans Country/Region as subject: Asia Language: English Journal: Endocr J Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: Endocrj.ej20-0613