Fegan, P. Gerry, Sandeman, Derek D., Krone, Nils, Bosman, Deborah, Wood, Peter J., Stewart, Paul M. and Hanley, Neil A.
Cushing's syndrome in women with polycystic ovaries and hyperandrogenism
Nature Clinical Practice Endocrinology & Metabolism, 3, (11), . (doi:10.1038/ncpendmet0665).
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BACKGROUND: A 41-year-old woman presented to an endocrinology-gynecology clinic having been diagnosed 7 years earlier with polycystic ovarian syndrome on account of hirsutism, subfertility, greasy skin, acne and multiple ovarian cysts. Ovulation induction had led to a successful pregnancy. Subfertility recurred, however, and persisted alongside a new diagnosis of hypertension and progressive weight gain. Upon examination, the patient was hypertensive with facial plethora, rounded facies and violaceous abdominal striae. INVESTIGATIONS: Low-dose dexamethasone test, bedtime salivary and 24-h urinary free cortisol estimations, CT scan of the abdomen, and serum hormone and gonadotropin analyses. DIAGNOSIS: Cushing's syndrome due to a right adrenocortical adenoma. MANAGEMENT: The patient underwent laparoscopic right adrenalectomy, which led to resolution of all symptoms, signs and biochemical abnormalities
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