Startseite A rare case of familial Cushing’s syndrome with a common presentation of weight gain due to a mutation of the PRKAR1A gene causing isolated primary pigmented nodular adrenocortical disease
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

A rare case of familial Cushing’s syndrome with a common presentation of weight gain due to a mutation of the PRKAR1A gene causing isolated primary pigmented nodular adrenocortical disease

  • Thekla Poukoulidou , Dominique Maiter , Jerome Bertherat und Veronique Beauloye EMAIL logo
Veröffentlicht/Copyright: 23. Mai 2014

Abstract

Background: Cushing’s syndrome (CS) is uncommon in childhood and adolescence. Variable presentation with subtle symptoms and signs can make diagnosis difficult.

Case report: We report the case of a 17-year-old girl referred for acne and progressive weight gain with an adrenocorticotropic hormone-independent CS. A computed tomography scan of the adrenals showed normal-sized adrenal glands with discrete bilateral shape irregularity. Bilateral adrenalectomy was performed and the histopathological findings were characteristic of primary pigmented nodular adrenocortical disease (PPNAD). Genetic analysis confirmed a germline mutation of the PRKAR1A gene. The same mutation was found in her sister, mother, and maternal grandfather. Endocrine tests showed that the sister of our patient also presented PPNAD requiring bilateral adrenalectomy and a similar histopathological pattern was observed. No other features of Carney complex was found among all affected members of the family.

Conclusion: It is exceptional for PPNAD to be an isolated phenomenon as well as being revealed by progressive weight gain in adolescence.


Corresponding author: Prof. Veronique Beauloye, MD, PhD, Unité d’Endocrinologie Pédiatrique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av Hippocrate 10/1300, B-1200 Bruxelles, Belgique, Phone: +3227641370, Fax: +3227648993, E-mail:

References

1. Chan L, Storr H, Grossman A, Savage M. Pediatric Cushing’s syndrome: clinical features, diagnosis and treatment. Arq Bras Endocrinol Metab 2007;51/8:1261–71.10.1590/S0004-27302007000800012Suche in Google Scholar

2. Greening JE, Storr HL, McKenzie SA, Davies KM, Martin L, et al. Linear growth and body mass index in pediatric patients with Cushing’s disease or simple obesity. J Endocrinol Invest 2006;29:885–7.10.1007/BF03349191Suche in Google Scholar

3. Newell-Price J, Bertagna X, Grossman AB, Nieman LK. Cushing’s syndrome. Lancet 2006;367:1605–17.10.1016/S0140-6736(06)68699-6Suche in Google Scholar

4. Magiakou MA, Chrousos GP. Cushing’s syndrome in children and adolescents: current diagnostic and therapeutic strategies. J Endocrinol Invest 2002;25:181–94.10.1007/BF03343985Suche in Google Scholar PubMed

5. Stratakis CA, Kirschner LS, Carney JA. Clinical and molecular features of the Carney complex: diagnostic criteria and recommendations for patient evaluation. J Clin Endocrinol Metab 2001;86:4041–6.10.1210/jcem.86.9.7903Suche in Google Scholar PubMed

6. Groussin L, Cazabat L, René-Corail F, Jullian E, Berherat J. Adrenal pathophysiology: lessons from the Carney complex. Horm Res 2005;64:132–9.10.1159/000088586Suche in Google Scholar PubMed

7. Gunther DF, Bourdeau I, Matyakhina L, Cassarino D, Kleiner DE, et al. Cyclical Cushing syndrome presenting in infancy: an early form of primary pigmented nodular adrenocortical disease, or a new entity? J Clin Endocrinol Metab 2004;89:3173–82.10.1210/jc.2003-032247Suche in Google Scholar PubMed

8. Cazabat L, Ragazzon B, Groussin L, Bertherat J. PRKAR1A mutations in primary pigmented nodular adrenocortical disease. Pituitary 2006;9:211–9.10.1007/s11102-006-0266-1Suche in Google Scholar PubMed

9. Groussin L, Horvath A, Jullian E, Boikos S, René-Corail F, et al. A PRKAR1A mutation associated with primary pigmented nodular adrenocortical disease in 12 kindreds. J Clin Endocrinol Metab 2006;91:1943–9.10.1210/jc.2005-2708Suche in Google Scholar PubMed

10. Robinson-White A, Meoli E, Stergiopoulos S, Horvath A, Boikos S, et al. PKAR1A mutations and protein kinase A interactions with other signaling pathways in the adrenal cortex. J Clin Endocrin Metab 2006;91:2380–8.10.1210/jc.2006-0188Suche in Google Scholar PubMed

11. Almeida MQ, Stratakis CA. Carney complex and other conditions associated with micronodular adrenal hyperplasias. Best Pract Res Clin Endocrinol Metab 2010;24:907–14.10.1016/j.beem.2010.10.006Suche in Google Scholar PubMed PubMed Central

Received: 2014-1-14
Accepted: 2014-4-22
Published Online: 2014-5-23
Published in Print: 2014-9-20

©2014 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Review article
  3. Towards an optimization of the management of endocrine complications of thalassemia
  4. Original articles
  5. The natural course of Hashimoto’s thyroiditis in children and adolescents
  6. Muscle strength and body composition during the transition phase in patients treated with recombinant GH to final height
  7. Benign vaginal bleeding in 24 prepubertal patients: clinical, biochemical and imaging features
  8. Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
  9. Counseling patients with succinate dehydrogenase subunit defects: genetics, preventive guidelines, and dealing with uncertainty
  10. Pubertal development profile in patients with Turner syndrome
  11. A novel CASR mutation associated with neonatal severe hyperparathyroidism transmitted as an autosomal recessive disorder
  12. Serum insulin-like growth factor-binding protein-3 level correlated with glycemic control and lipid profiles in children and adolescents with type 1 diabetes
  13. Adult human liver mesenchymal progenitor cells express phenylalanine hydroxylase
  14. Clinical applicability of rapid detection of SRY and DYS14 genes in patients with disorders of sex development using an indigenously developed 5′ exonuclease based assay
  15. Hereditary 1,25-dihydroxyvitamin D-resistant rickets with alopecia in four Egyptian families: report of three novel mutations in the vitamin D receptor gene
  16. Permanent neonatal diabetes mellitus in Jordan
  17. The effect of adenotonsilectomy on ghrelin, leptin, IGF-1 levels and growth parameters in children with adenotonsillar hypertrophy
  18. The role of anti-Mullerian and inhibin B hormones in the evaluation of 46,XY disorders of sex development
  19. The evaluation of thyroid carcinoma in childhood and concomitance of autoimmune thyroid disorders
  20. Lipid patterns in treated growth hormone deficient children vs. short stature controls
  21. Assessment of aortic morphology and compliance in children and adolescents with Ullrich-Turner syndrome (UTS) using magnetic resonance imaging (MRI)
  22. Management of central diabetes insipidus with oral desmopressin lyophilisate in infants
  23. Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone
  24. Patient reports
  25. A rare case of pituitary infarction leading to spontaneous tumour resolution and CSF-sella syndrome in an 11-year-old girl and a review of the paediatric literature
  26. Rare case of homozygous epimerase deficiency and heterozygous of duarte 2 variant
  27. Persistent congenital hyperinsulinism in two patients with Beckwith-Wiedemann syndrome due to mosaic uniparental disomy 11p
  28. Growth hormone treatment in a patient with Hurler-Scheie syndrome
  29. Neonatal diagnosis of a patient with hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR) syndrome associated with cerebral infarction
  30. Early-onset diabetes mellitus and neurodevelopmental retardation: the first Greek case of Wolcott-Rallison syndrome
  31. Type III Bartter-like syndrome in an infant boy with Gitelman syndrome and autosomal dominant familial neurohypophyseal diabetes insipidus
  32. Cushing’s syndrome: hidden risk in usage of topical corticosteroids
  33. Prader-Willi syndrome: a case report with atypical developmental features
  34. Berardinelli-Seip congenital lipodystrophy: an autosomal recessive disorder with rare association of duodenocolonic polyps
  35. Ectopic Cushing syndrome secondary to metastatic medullary thyroid cancer in a child with multiple endocrine neoplasia syndrome type 2B: clues to early diagnosis of the paraneoplastic syndromes
  36. Ovarian hyperstimulation syndrome treated by medroxyprogesterone acetate
  37. Symptomatic cerebral infarction in a child with severe diabetic ketoacidosis
  38. A rare case of familial Cushing’s syndrome with a common presentation of weight gain due to a mutation of the PRKAR1A gene causing isolated primary pigmented nodular adrenocortical disease
  39. Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: is there an association? A case report and literature review
  40. Cholestasis and protein-losing enteropathy secondary to hyperthyroidism in a 6-year-old girl
  41. Short communication
  42. An essential splice site mutation (c.317+1G>A) in the TSHR gene leads to severe thyroid dysgenesis
  43. Letter to the Editor
  44. Pubertal gynecomastia: what about the remaining 10%?
Heruntergeladen am 20.11.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpem-2014-0018/html
Button zum nach oben scrollen