Cushing’s disease presenting with psychosis

Cushing’s disease is a rare endocrine condition in which a pituitary corticotroph adenoma drives excess adrenal cortisol production, and is one cause of endogenous Cushing’s syndrome. We present a young woman with 3 weeks of headaches and cognitive disturbance who subsequently developed florid psych...

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Bibliographic Details
Published inPractical neurology Vol. 21; no. 4; pp. 351 - 353
Main Authors Mubarak Mohamed, Ahmed Saeed, Iqbal, Ahmed, Prasad, Suveera, Hoggard, Nigel, Blackburn, Daniel
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group LTD 01.08.2021
Subjects
Abdomen
Anxiety
Atrophy
Biochemistry
Cushing syndrome
Dehydrogenases
Endocrinology
Hormones
Hypokalemia
Medical imaging
Memory
Mental health
Neurology
Ovaries
Patients
Physiology
Pituitary gland
Polycystic ovary syndrome
Potassium
Psychosis
Systematic review
Trust departments
Tumors
United Kingdom > UK
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Summary:Cushing’s disease is a rare endocrine condition in which a pituitary corticotroph adenoma drives excess adrenal cortisol production, and is one cause of endogenous Cushing’s syndrome. We present a young woman with 3 weeks of headaches and cognitive disturbance who subsequently developed florid psychosis requiring multiple admissions under neurology and psychiatry. Her clinical stigmata of hypercortisolism and biochemical abnormalities prompted an MR scan of the pituitary, which confirmed a pituitary microadenoma. Treatment with metyrapone and subsequent surgery led to complete recovery within 2 months. Cushing’s disease commonly causes neuropsychiatric symptoms and can present with psychosis. Diagnosing Cushing’s disease can be challenging, but with early diagnosis and treatment it has an excellent prognosis.
ISSN:1474-7758
1474-7766
DOI:10.1136/practneurol-2021-002974