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Recovery from severe osteoporosis following cure from ectopic ACTH syndrome caused by an appendix carcinoid.

Authors
  • Dobnig, H
  • Stepan, V
  • Leb, G
  • Wolf, G
  • Buchfelder, M
  • Krejs, G J
Type
Published Article
Journal
Journal of internal medicine
Publication Date
Apr 01, 1996
Volume
239
Issue
4
Pages
365–369
Identifiers
PMID: 8774392
Source
Medline
License
Unknown

Abstract

It is well established that endogenous overproduction of glucocorticoids may cause osteoporosis. However, knowledge about potential recovery of the skeleton after cessation of corticosteroid excess is limited. We describe a 34-year-old female patient and discuss the complex diagnostic workup that led to the rare diagnosis of carcinoid of the appendix as the cause of Cushing's syndrome. The patient experienced multiple spontaneous rip fractures, and at that time, the bone mineral density of the lumbar spine was 4.3 SD below values for age-matched healthy controls. After removal of the tumour, the patient completely recovered. Measurements at the lumbar spine showed an increase in area bone density of 79% equivalent to 4 SD over a subsequent 3-year observation period. This first case of documented bone mass recovery in a patient cured of ectopic ACTH syndrome suggests a potential for excellent reversibility of steroid-induced osteoporosis and should be considered in the management of such patients.

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