Secrecion ectopica de acth. Sindrome de cushing paraneoplasico por carcinoma de pulmon
Ectopic secretion of acth. Cushing's paraneoplasic syndrome by lung cancer
J.R. Muñoz, A. Portolés, G. Moyano, C. Rubín de Celis, E. Navarro, J. Sardaña
Departamento de Medicina Interna. Servicio de Medicina Interna. Ciudad Sanitaria de la Seguridad Social. Zaragoza
* Servicio de Anatomía Patológica. Departamento de Medicina Interna. Servicio de Medicina Interna. Ciudad Sanitaria de la Seguridad Social. Zaragoza
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Sindrome de cushing paraneoplasico por carcinoma de pulmon" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "35" "paginaFinal" => "39" ] ] "autores" => array:2 [ 0 => array:3 [ "autoresLista" => "J.R. Muñoz, A. Portolés, G. Moyano, C. Rubín de Celis, E. Navarro, J. Sardaña" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.R." "apellidos" => "Muñoz" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Portolés" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Moyano" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Rubín de Celis" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Navarro" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Sardaña" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Medicina Interna. Servicio de Medicina Interna. Ciudad Sanitaria de la Seguridad Social. Zaragoza" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "autoresLista" => "A. Gracia, L. Plaza" "autores" => array:2 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Gracia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Plaza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Anatomía Patológica. Departamento de Medicina Interna. Servicio de Medicina Interna. Ciudad Sanitaria de la Seguridad Social. Zaragoza" "etiqueta" => "*" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ectopic secretion of acth. Cushing's paraneoplasic syndrome by lung cancer" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presenta el estudio de un caso de síndrome de secreción ectópica de ACTH como manifestación de un carcinoma de pulmón y caracterizado por un síndrome de Cushing paraneoplásico.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los datos de la clínica manifiestan un proceso de rápida evolución que se expresa con una sintomatología de alcalosis metabólica, diabetes no compensada y resistente a la insulina, hiperpigmentación y equimosis manifiesta. Asimismo, aparece una alteración general correspondiente a la neoplasia. Analíticamente aparece una elevación de cortisol plasmático, con pérdida del ritmo circadiano; gran eliminación de 17 OHS y 17 KS en orina y falta de supresión de actividad con la administración de dexametasona y no estímulo con ACTH.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Las imágenes radiográficas de pulmón, demuestran la existencia de una tumoración claramente definida. Anatomopatologicamente se comprueba el diagnóstico de un carcinoma microcito en células en avena (oat-cell), con metástasis a nivel hepático, medular y suprarrenal.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se discuten los síndromes de secreción ectópica de ACTH, que como tal ha de acompañarse de síndrome de Cushing y se comenta la incidencia de los síndromes paraneoplásicos en los cánceres de pulmón así como la aparición de este síndrome endocrino en otros tumores.</p></span>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The authors present the study of a case of syndrome of ectopic secretion of ACTH as a manifestation of lung cáncer and characterized by Cushing's paraneoplasic syndrome.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Data of the clinical history show a process of rapid evolution expressed with a symptomatology ofmetabolic alkalosis, non compensated diabetes resistant to insulin, hyperpigmentation and manifest ecchymosis. There is also a general alteration corresponding to neoplasia. Analytically, an elevation of plasmatic cortisol appears, with loss of circadian rhythm; great elimination of 17 OHS and 17KS in the uriñe and lack of suppression of activity with the administration of dexamethasone and non-stimulation with ACTH.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The radiographic images of the lung show the existence of a tumor, clearly defined. The diagnosis of a microcytic carcinoma in oat-cells with metástasis at the hepatic, medular and suprarenal levels is verified anatomicopathologically.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Finally, the authors discuss the syndromes of ectopic secretion of ACTH that, as such accompany Cushing's syndrome and comment on the incidence of paraneoplasic syndromes in lung cancers as well as the appearance of this endocrine syndrome in other tumors.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 22 | 4 | 26 |
| 2024 October | 162 | 31 | 193 |
| 2024 September | 130 | 22 | 152 |
| 2024 August | 174 | 37 | 211 |
| 2024 July | 131 | 39 | 170 |
| 2024 June | 158 | 26 | 184 |
| 2024 May | 165 | 45 | 210 |
| 2024 April | 113 | 50 | 163 |
| 2024 March | 138 | 38 | 176 |
| 2024 February | 96 | 47 | 143 |
| 2024 January | 0 | 11 | 11 |
| 2023 December | 0 | 8 | 8 |
| 2023 November | 0 | 4 | 4 |
| 2023 October | 0 | 16 | 16 |
| 2023 September | 0 | 2 | 2 |
| 2023 August | 0 | 3 | 3 |
| 2023 July | 0 | 20 | 20 |
| 2023 April | 0 | 1 | 1 |
| 2023 March | 17 | 9 | 26 |
| 2023 February | 117 | 40 | 157 |
| 2023 January | 112 | 57 | 169 |
| 2022 December | 95 | 37 | 132 |
| 2022 November | 219 | 33 | 252 |
| 2022 October | 110 | 64 | 174 |
| 2022 September | 125 | 75 | 200 |
| 2022 August | 110 | 54 | 164 |
| 2022 July | 127 | 39 | 166 |
| 2022 June | 104 | 62 | 166 |
| 2022 May | 122 | 64 | 186 |
| 2022 April | 105 | 69 | 174 |
| 2022 March | 102 | 50 | 152 |
| 2022 February | 113 | 95 | 208 |
| 2022 January | 129 | 93 | 222 |
| 2021 December | 99 | 77 | 176 |
| 2021 November | 109 | 111 | 220 |
| 2021 October | 228 | 124 | 352 |
| 2021 September | 98 | 82 | 180 |
| 2021 August | 84 | 110 | 194 |
| 2021 July | 75 | 47 | 122 |
| 2021 June | 77 | 101 | 178 |
| 2021 May | 147 | 133 | 280 |
| 2021 April | 359 | 290 | 649 |
| 2021 March | 184 | 108 | 292 |
| 2021 February | 143 | 58 | 201 |
| 2021 January | 151 | 105 | 256 |
| 2020 December | 253 | 96 | 349 |
| 2020 November | 303 | 111 | 414 |
| 2020 October | 165 | 121 | 286 |
| 2020 September | 141 | 106 | 247 |
| 2020 August | 115 | 80 | 195 |
| 2020 July | 143 | 92 | 235 |
| 2020 June | 151 | 122 | 273 |
| 2020 May | 179 | 191 | 370 |
| 2020 April | 137 | 171 | 308 |
| 2020 March | 128 | 125 | 253 |
| 2020 February | 127 | 126 | 253 |
| 2020 January | 217 | 84 | 301 |
| 2019 December | 145 | 72 | 217 |
| 2019 November | 114 | 115 | 229 |
| 2019 October | 110 | 96 | 206 |
| 2019 September | 148 | 82 | 230 |
| 2019 August | 65 | 49 | 114 |
| 2019 July | 107 | 77 | 184 |
| 2019 June | 119 | 85 | 204 |
| 2019 May | 202 | 124 | 326 |
| 2019 April | 155 | 122 | 277 |
| 2019 March | 71 | 90 | 161 |
| 2019 February | 45 | 37 | 82 |
| 2019 January | 32 | 26 | 58 |
| 2018 December | 36 | 34 | 70 |
| 2018 November | 75 | 35 | 110 |
| 2018 October | 39 | 25 | 64 |
| 2018 September | 26 | 13 | 39 |
| 2018 May | 11 | 1 | 12 |
| 2018 April | 16 | 7 | 23 |
| 2018 March | 3 | 4 | 7 |
| 2018 February | 9 | 10 | 19 |
| 2018 January | 7 | 6 | 13 |
| 2017 December | 5 | 14 | 19 |
| 2017 November | 13 | 21 | 34 |
| 2017 October | 8 | 27 | 35 |
| 2017 September | 6 | 17 | 23 |
| 2017 August | 8 | 21 | 29 |
| 2017 July | 5 | 10 | 15 |
| 2017 June | 9 | 30 | 39 |
| 2017 May | 11 | 18 | 29 |
| 2017 April | 4 | 10 | 14 |
| 2017 March | 6 | 45 | 51 |
| 2017 February | 10 | 10 | 20 |
| 2017 January | 4 | 17 | 21 |
| 2016 December | 12 | 14 | 26 |
| 2016 November | 20 | 13 | 33 |
| 2016 October | 13 | 24 | 37 |
| 2016 September | 5 | 15 | 20 |
| 2016 August | 22 | 7 | 29 |
| 2016 July | 11 | 6 | 17 |
| 2016 June | 19 | 10 | 29 |
| 2016 May | 25 | 9 | 34 |
| 2016 April | 9 | 0 | 9 |
| 2016 March | 12 | 0 | 12 |
| 2016 February | 13 | 1 | 14 |
| 2016 January | 12 | 4 | 16 |
| 2015 December | 18 | 10 | 28 |
| 2015 November | 31 | 15 | 46 |
| 2015 October | 6 | 1 | 7 |
| 2015 September | 2 | 0 | 2 |
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