期刊
INTERNAL MEDICINE
卷 46, 期 14, 页码 1117-1122出版社
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.46.6436
关键词
Cushing's disease; bromocriptine; impaired ocular movement; type 2 diabetes
资金
- Ministry of Education, Science, Sports and Technology
- Ministry of Health, Labor and Welfare in Japan
A 73-year-old woman presented with disturbance of right eyelid opening with ptosis and impairment of right ocular movement, and later was found to have Cushingoid features. Endocrine examinations revealed that plasma ACTH and cortisol levels were elevated, lack of circadian rhythm, resistant to low-doses (0.5, 1, 2 mg) and high-dose (8 mg) dexamethasone, and responsive to CRH and DDAVP. Magnetic resonance imaging (MRI) revealed a large pituitary tumor invading the right cavernous sinus. After two months treated with bromocriptine (5 mg/ day), she showed clinical improvement with normalization of plasma ACTH and cortisol levels, and improvement of right eyelid opening and ocular movement. MRI, however, revealed no apparent reduction in the size of pituitary tumor. This is a rare case of bromocriptine-responsive Cushing's disease.
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