Ectopic ACTH syndrome

Ectopic ACTH syndrome Description, Causes and Risk Factors: Abbreviation: EAS. The ectopic ACTH syndrome was ?rst described in 1928 by Brown as a `pluriglandular syndrome of the bearded woman', and subsequently by Leyton who described a patient with thymus cancer and ectopic ACTH secretion. The term `ectopic ACTH syndrome' is considered a misnomer by some authors, since many non-neoplasic tissues produce ACTH. However, the majority of mRNA for proopiomelanocortin (POMC) in peripheral tissues is the 800 nt transcript that lacks the signal sequence encoded in exons 1 and 2, and although translated it is unlikely to cross endoplasmic reticulum for processing. In these tissues, the ACTH produced is truncated and thus has lower biological activity due to the lack of adequate processing of POMC. The EAS occurs in around 5-10% of all cases of ACTH-dependent hypercortisolism. Different from Cushing's disease, which presents a predominance of 75-80% in the female sex, the EAS is only slightly more frequent in women. The mean age of clinical presentation, as shown in several series published in the literature, varies from 45 to 50 years, being higher when compared with the mean age of Cushing's disease, which is 30-40 years. The most common places for an ectopic ACTH-producing tumor are in the lung and thymus, both located in the chest. Other very rare places include the thyroid, ovary, adrenal gland, and liver. Just like a pituitary adenoma, these ACTH-producing tumors make too much ACTH and in turn cause the adrenal glands to make too much cortisol. Symptoms:Ectopic ACTH syndrome Irritability.
  • Mania.
  • Depression.
  • Psychosis.
  • Diabetes mellitus (<20%).
  • Osteoporosis.
  • Weakness (proximal muscles) andfatigue.
  • Leukocytosis
  • Hyperlipidemia.
Diagnosis: Localization of the ACTH-secreting tumor is often difficult and may require multiple modalities, including computed tomography (CT), magnetic resonance imaging (MRI), and octreotide scanning to lessen the likelihood of false-positive results by a single imaging technique. Treatment: Optimal treatment for ectopic ACTH syndrome is dependent on the ability to localize the source of ACTH. Surgical resection of the source may be curative in many cases. In other cases, treatment by bilateral adrenalectomy or steroidogenesis inhibitors may need to be considered as options or to control the hypercortisolemia during the localization process. Patients with ectopic ACTH syndrome caused by occult neuroendocrine tumors have a more favorable prognosis than cases caused by small-cell lung cancer, medullary carcinoma of the thyroid, or gastrinoma. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

0 Comments

Submit a Comment

Your email address will not be published. Required fields are marked *

Cart Preview

Regular Exercising May Keep Your Heart and Main Arteries Young

Regular Exercising May Keep Your Heart and Main Arteries Young

According to a recent study, published in The Journal of Physiology, exercising four to five times per week may help stop the main arteries to the heart from stiffening up. The researchers from the US have found that those who exercise four to five times per week had...

Intermittent Fasting May Increase the Risk of Type 2 Diabetes

Intermittent Fasting May Increase the Risk of Type 2 Diabetes

A new study from Brazil suggests that trendy intermittent fasting may be the reason for increasing insulin levels and the amount of abdominal fat. It also may lead to the damage of pancreatic cells. Intermittent fasting diet is a diet when a dieting person has “fast”...

Quiz about this article

Please answer on few questions to make our service more useful

Featured Products

Spring is Here: Top 6 Outdoor Sports

Good weather is the best reason to do outdoor sports, which will help not only lose weight, but also will strengthen health. Bicycle The sun dries out the local paths, so you can safely sit on your favorite bike and confidently twist the pedals, where the eyes look....

read more

First Aid in Case of Injuries for Sport and Exercise

First aid for injuries consists of simple rules that need to be clearly implemented. If this is a closed injury, you need to immobilize the injured limb, otherwise the person may lose consciousness from a painful shock. If you need to get to the emergency room...

read more