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Successful management of a patient with active Cushing‍’‍s disease complicated with coronavirus disease 2019 (COVID-19) pneumonia

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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
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
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)

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