Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report
Hypophosphatemia is an unusual cause of acute respiratory distress syndrome (ARDS). We describe a hypophosphatemia-related ARDS case report of a 50-year-old woman with ACTH dependent Cushing's syndrome secondary to ectopic CRH production. The patient clinically showed hypotension tachypnea and...
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| Format: | Article |
| Language: | English |
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Wiley
2008-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1100/tsw.2008.20 |
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| author | Stefania Mondello Vincenzo Fodale Salvatore Cannav Carmela Aloisi Barbara Almoto Michele Buemi Letterio B. Santamaria |
| author_facet | Stefania Mondello Vincenzo Fodale Salvatore Cannav Carmela Aloisi Barbara Almoto Michele Buemi Letterio B. Santamaria |
| author_sort | Stefania Mondello |
| collection | DOAJ |
| description | Hypophosphatemia is an unusual cause of acute respiratory distress syndrome (ARDS). We describe a hypophosphatemia-related ARDS case report of a 50-year-old woman with ACTH dependent Cushing's syndrome secondary to ectopic CRH production. The patient clinically showed hypotension tachypnea and increasing dyspnea. Laboratory data showed carbohydrate intolerance, severe hypokalemia, and hypophosphatemia. Arterial blood gases measurement revealed hypocapnia and elevation in bicarbonate values. Chest X-ray showed diffuse bilateral alveolar infiltrates similar to acute pulmonary edema and Kerley's striae. Chest CT scan evidenced diffuse ground glass opacification, bilateral patchy consolidation, and fibrosis, compatible with the recovery phase of ARDS. Clinical symptoms and laboratory examinations supported the diagnosis of ARDS. The patient was managed with supplemental potassium, octreotide, and oxygen therapy. Hypophosphatemia was managed by treating the underlying disorder. Successive surgical removal of the adrenal gland led to complete resolution of Cushing's syndrome. In conclusion, although rare and associated with specific risk factors, hypophosphatemia should be suspected in patients who develop unexplained ARDS. |
| format | Article |
| id | doaj-art-dd1ebfc62b1141178a6cfbea9994d892 |
| institution | OA Journals |
| issn | 1537-744X |
| language | English |
| publishDate | 2008-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-dd1ebfc62b1141178a6cfbea9994d8922025-08-20T02:21:33ZengWileyThe Scientific World Journal1537-744X2008-01-01813814410.1100/tsw.2008.20Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case ReportStefania Mondello0Vincenzo Fodale1Salvatore Cannav2Carmela Aloisi3Barbara Almoto4Michele Buemi5Letterio B. Santamaria6Department of Internal Medicine, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyDepartment of Neurosciences, Psychiatric and Anesthesiological Sciences, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyDepartment of Internal Medicine, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyDepartment of Internal Medicine, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyDepartment of Internal Medicine, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyDepartment of Internal Medicine, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyDepartment of Neurosciences, Psychiatric and Anesthesiological Sciences, University of Messina, School of Medicine, Policlinico Universitario “G.Martino”, 98125 Messina, ItalyHypophosphatemia is an unusual cause of acute respiratory distress syndrome (ARDS). We describe a hypophosphatemia-related ARDS case report of a 50-year-old woman with ACTH dependent Cushing's syndrome secondary to ectopic CRH production. The patient clinically showed hypotension tachypnea and increasing dyspnea. Laboratory data showed carbohydrate intolerance, severe hypokalemia, and hypophosphatemia. Arterial blood gases measurement revealed hypocapnia and elevation in bicarbonate values. Chest X-ray showed diffuse bilateral alveolar infiltrates similar to acute pulmonary edema and Kerley's striae. Chest CT scan evidenced diffuse ground glass opacification, bilateral patchy consolidation, and fibrosis, compatible with the recovery phase of ARDS. Clinical symptoms and laboratory examinations supported the diagnosis of ARDS. The patient was managed with supplemental potassium, octreotide, and oxygen therapy. Hypophosphatemia was managed by treating the underlying disorder. Successive surgical removal of the adrenal gland led to complete resolution of Cushing's syndrome. In conclusion, although rare and associated with specific risk factors, hypophosphatemia should be suspected in patients who develop unexplained ARDS.http://dx.doi.org/10.1100/tsw.2008.20 |
| spellingShingle | Stefania Mondello Vincenzo Fodale Salvatore Cannav Carmela Aloisi Barbara Almoto Michele Buemi Letterio B. Santamaria Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report The Scientific World Journal |
| title | Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report |
| title_full | Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report |
| title_fullStr | Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report |
| title_full_unstemmed | Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report |
| title_short | Hypophosphatemia as Unusual Cause of ARDS in Cushing’s Syndrome Secondary to Ectopic CRH Production. A Case Report |
| title_sort | hypophosphatemia as unusual cause of ards in cushing s syndrome secondary to ectopic crh production a case report |
| url | http://dx.doi.org/10.1100/tsw.2008.20 |
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