Persistent hypokalemia after successful adrenalectomy in a patient with Cushing's syndrome due to ectopic ACTH secretion

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dc.contributor.authorArteaga, E
dc.contributor.authorFardella, C
dc.contributor.authorCampusano, C
dc.contributor.authorCárdenas, I
dc.contributor.authorMartinez, P
dc.date.accessioned2025-01-21T01:31:46Z
dc.date.available2025-01-21T01:31:46Z
dc.date.issued1999
dc.description.abstractEctopic ACTH secretion is characterized by a high incidence of hypokalemia. The pathophysiology of hypokalemia has not been totally clarified, although it has been postulated that excessive amounts of adrenal steroids may play a role, as well as a possible role of the inhibition of the enzyme 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD). This enzyme normally converts cortisol to cortisone avoiding the mineralocorticoid action of cortisol. We present a patient with ectopic ACTH secretion due to a metastatic carcinoid tumor. The clinical picture was characterized by maintained hypokalemia (1.4 mmol/l) resistant to potassium, spironolactone and ketoconazole administration. A bilateral adrenalectomy was performed but the hypokalemia persisted while he was receiving a physiological dose of cortisol. Eight days after adrenalectomy cortisol was replaced by an equivalent dose of dexamethasone. This change was followed by a rapid and persistent normalization of hypokalemia suggesting a mineralocorticoid effect of cortisol. In conclusion, the origin of hypokalemia in our patient with ectopic ACTH secretion was secondary to cortisol. We postulate that this peculiar effect of cortisol could have happened if an inhibition of 11 beta-OHSD occurred. (J. Endocrinol. Invest. 22: 857-859, 1999) (C) 1999, Editrice Kurtis.
dc.fuente.origenWOS
dc.identifier.issn0391-4097
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/97137
dc.identifier.wosidWOS:000085034300007
dc.issue.numero11
dc.language.isoen
dc.pagina.final859
dc.pagina.inicio857
dc.revistaJournal of endocrinological investigation
dc.rightsacceso restringido
dc.subjectCushing's syndrome
dc.subjectACTH
dc.subject11 beta-OHSD
dc.subjecthypokalemia
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePersistent hypokalemia after successful adrenalectomy in a patient with Cushing's syndrome due to ectopic ACTH secretion
dc.typeartículo
dc.volumen22
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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