Endocrinology and Metabolism

Yu Bai Ahn (Ahn YB)

3 Articles

Two Cases of Primary Hyperparathyroidism Associated with Colon Cancer.: Sang Hoon Chun, Yun Kyung Kim, Jae Seung Yun, Eun Hee Jang, Shin Ae Park, Jae Hyung Cho, Seung Hyun Ko, Yu Bai Ahn, Young Jin Suh, Jun Gi Kim; J Korean Endocr Soc. 2008;23(3):204-209. Published online June 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.3.204

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Abstract PDF: Hypercalcemia is often observed in cancer patients secondary to parathyroid hormone (PTH) related peptide production. However, primary hyperparathyroidism and colon cancer rarely present simultaneously. Calcium is believed to have a chemopreventive effect against colorectal cancer because it reduces crypt cell hyperproliferation in both humans and in animals. There is evidence to suggest that the incidence of colorectal cancer in humans is reduced by high calcium intake. In patients with primary hyperparathyroidism, increased PTH activates 1,25(OH)2D and enhances calcium absorption in the gut. Consequently, the calcium level in the lumen is decreased, leading to an elevated risk of colorectal cancer. We report two patients with colon cancer and hypercalcemia secondary to primary hyperparathyroidism, along with a brief review of the literature.

A Case of Ectopic ACTH Syndrome Associated with Small Cell Lung Cancer Presented with Hypokalemia.: Hong Jun Yang, Hea Jung Sung, Ji Eun Kim, Hyo Jin Lee, Jin Min Park, Chan Kwon Park, Eun Suk Roh, Jae Hyung Cho, Seung Hyun Ko, Ki Ho Song, Yu Bai Ahn; J Korean Endocr Soc. 2007;22(5):359-364. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.359

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Abstract PDF

We report a case of a 73-year-old female patient who was diagnosed with ectopic ACTH syndrome caused by small cell lung cancer. We initially presumed that the patient was in a state of mineralocorticoid excess, because she had hypertension and hypokalemic alkalosis. This was however excluded because her plasma renin activity was not suppressed and her plasma aldosterone/plasma renin activity ratio was below 25. Moreover, her 24 hour urine free cortisol level was elevated and her serum cortisol levels after a low dose dexamethasone suppression test, were not suppressed. Furthermore, her basal plasma ACTH and serum cortisol levels increased and her serum cortisol level after a high dose dexamethasone suppression test was not suppressed. We performed studies to identify the source of ectopic ACTH syndrome and found a 3 cm-sized mass in the patient's right lower lobe of her lung, which was eventually diagnosed as small cell lung cancer following a bronchoscopic biopsy. In conclusion, Cushing's syndrome, and in particular ectopic ACTH syndrome, must be considered in the differential diagnosis of mineralocorticoid-induced hypertension. The excessive cortisol saturates the 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) activity, which in turn, inactivates the conversion of cortisol to cortisone in the renal tubules. Moreover, excessive cortisol causes binding to the mineralocorticoid receptors, causing mineralocorticoid hypertension, characterized by severe hypercortisolism.

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Emergencia hipertensiva como debut de síndrome de Cushing paraneoplásico
E. Rubio González, M. de Valdenebro Recio, M.I. Galán Fernández
Hipertensión y Riesgo Vascular.2024; 41(2): 135. CrossRef
Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review
Yanlong Li, Caiyu Li, Xiangjun Qi, Ling Yu, Lizhu Lin
Frontiers in Endocrinology.2023;[Epub] CrossRef
Ectopic Cushing Syndrome in Adenocarcinoma of the Lung: Case Report and Literature Review
Rana Al-Zakhari, Safa Aljammali, Basma Ataallah, Svetoslav Bardarov, Philip Otterbeck
Cureus.2021;[Epub] CrossRef
A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer
Chaiho Jeong, Jinhee Lee, Seongyul Ryu, Hwa Young Lee, Ah Young Shin, Ju Sang Kim, Joong Hyun Ahn, Hye Seon Kang
Tuberculosis and Respiratory Diseases.2015; 78(4): 436. CrossRef

A Case of Cushing's Disease with Renal Cell Carcinomaand End-stage Renal Disease.: Jang Eun Lee, Ik Jun Choi, Young Jai Park, Hyo Jin Lee, Kyoung Hwan Lee, Seung Hyun Ko, Ki Ho Song, Yu Bai Ahn; J Korean Endocr Soc. 2007;22(1):62-67. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.62

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Abstract PDF: Cushing's disease is the most common cause of endogenous Cushing's syndrome caused by the excessive secretion of adrenocorticotropic hormone (ACTH) by pituitary ACTH-secreting tumors. The tumors are usually microadenomas (< 10 mm in diameter). Macroadenomas are rare, and corticotroph hyperplasia and carcinomas are extremely rare. Patients with these tumors exhibit an increase in plasma ACTH and cortisol levels, elevated urinary excretion of cortisol and adrenocortical steroid metabolites, evidence of altered negative feedback of cortisol and disturbances in neuroendocrine regulation. The diagnosis of Cushing's disease can be challenging in patients with renal failure the presence of abnormal plasma cortisol, poor gastrointestinal tract absorption of dexamethasone and altered functioning of the hypophyseal-pituitary-adrenal axis have been reported in end-stage renal disease, and the urinary cortisol increment method is not reliable in these patients. The prevalence of renal cell carcinoma in patients on dialysis is higher than in the general population. We recently treated a patient with Cushing's disease and end-stage renal disease as a result of renal cell carcinoma. The diagnosis was made by laboratory evaluation of plasma and radiological examination. Here we report a case of Cushing's disease with a review of the medical literature.

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