| Title: | Successful management of a patient with active Cushing’s disease complicated with coronavirus disease 2019 (COVID-19) pneumonia |
| Authors: | Yuno, Akiko Browse this author |
| Kenmotsu, Yoshiyuki Browse this author |
| Takahashi, Yuka Browse this author |
| Nomoto, Hiroshi Browse this author →KAKEN DB |
| Kameda, Hiraku Browse this author →KAKEN DB |
| Cho, Kyu Yong Browse this author |
| Nakamura, Akinobu Browse this author →KAKEN DB |
| Yamashita, Yu Browse this author |
| Nakamura, Junichi Browse this author |
| Nakakubo, Sho Browse this author |
| Kamada, Keisuke Browse this author |
| Suzuki, Masaru Browse this author |
| Sugino, Hirokazu Browse this author |
| Inoshita, Naoko Browse this author |
| Konno, Satoshi Browse this author |
| Miyoshi, Hideaki Browse this author →KAKEN DB |
| Atsumi, Tatsuya Browse this author →KAKEN DB |
| Sawamura, Yutaka Browse this author |
| Shimatsu, Akira Browse this author |
| Keywords: | Cushing’s disease |
| Coronavirus disease 2019 |
| COVID-19 |
| Medical management |
| Block and replace regimen |
| Issue Date: | Feb-2021 |
| Publisher: | The Japan Endocrine Society |
| Journal Title: | Endocrine Journal |
| Volume: | 68 |
| Issue: | 4 |
| Start Page: | 477 |
| End Page: | 484 |
| Publisher DOI: | 10.1507/endocrj.EJ20-0613 |
| Abstract: | We provide the details of the successful management of a patient with active Cushing’s disease complicated with coronavirus disease 2019 (COVID-19) pneumonia. The patient was a 27-year-old Japanese female healthcare worker who was scheduled to undergo pituitary surgery for Cushing’s disease. She had been in close contact with an undiagnosed patient infected with COVID-19 and then developed COVID-19 pneumonia. Despite a lack of known risk factors associated with severe COVID-19 infection, the patient’s dyspnea worsened and her respiratory condition deteriorated, as indicated by the need for 7 L/min oxygen supply by mask to maintain her oxygen saturation at >90%. Medical treatment was initiated to control hypercortisolism by the ‘block and replace’ regimen using steroidogenesis inhibitors and hydrocortisone. The COVID-19 pneumonia improved with multi-modal treatment including antiviral therapy. One month later, after a negative severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) test result and with appropriate protection against virus transmission to medical staff in the operating room and daily medical care nurses, trans-sphenoidal surgery was performed by our highly experienced pituitary surgeon. One month after the surgery, the patient’s basal ACTH and cortisol levels and urinary free cortisol were all under the detection limit. Surgical remission was expected. Since hypercortisolism due to active Cushing’s disease may worsen a COVID-19 infection, multi-disciplinary management that includes appropriate and prompt treatment strategies is mandatory in such cases. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/81131 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
