Work

Diabetic Ketoacidosis as the First Manifestation of Ectopic Cushing’s Syndrome

Year: 2025

Type: article

Abstract: Diabetic ketoacidosis is an exceptionally rare initial manifestation of ectopic adrenocorticotropic hormone (ACTH) syndrome. A 42-year-old woman with multiple cardiovascular risk factors was admitted to the emergency room with diabetic ketoacidosis. During stabilization, florid Cushing's syndrome was suspected and confirmed biochemically as ACTH-dependent. Further biochemical and imaging surveys led to the diagnosis of a 25x15 mm nodule in the lingula. Thoracic surgery was performed, and pathology revealed a neuroendocrine tumor positive for ACTH. We reviewed eight additional cases of diabetic ketoacidosis associated with Cushing's syndrome from PubMed. Clinicians should bear in mind this etiology of diabetic ketoacidosis based on clinical signs and younger patients with multiple, age-atypical comorbidities. This would permit the expedited targeted stabilization of Cushing's syndrome and the suitable institution of the diagnostic approach and treatment for this challenging syndrome.

Source: Cureus

DOI: 10.7759/cureus.98305

Authors: Regina Medeiros, Vitor Carneiro, Isabel Sousa, Bernardo Dias Pereira

Institution: Hospital do Divino Espírito Santo

Language: English

Topic: Pituitary Gland Disorders and Treatments

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416914913