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+--- Thread: please help with this case - small_doctor (/showthread.php?tid=247336)
please help with this case - small_doctor - ArchivalUser - 11-28-2007
male patient aged 22 years old,medical student,complaining from purple reddish striea on his abdomen and flanks.
blood pressure 130/90.with visible suprastrnal pulsations.
investigation done and relieved the following
fasting blood sugar----?73.6 mg%
post prandial blood sugar--->115.8 mg%
urine sugar.acetone,albumin---->nil
ACTH am---?21.8 pg/ml
ACTH pm----?29.1
serum cortisol am--->13.9 ug/dl
serum cortisol pm---?15.2 ug/dl
serum potassium--->3.1 mmol/ml
what is the most accepted diagnosis?
please help
i suggest it may be cushing syndrome or anixety disorder(cortisol anti stress) waiting for ur feed back
thanx
0 - ArchivalUser - 11-28-2007
any one here ??!!
0 - ArchivalUser - 11-28-2007
I dont know!!
0 - ArchivalUser - 11-29-2007
thanx for ur reply
i reall confused with this case
0 - ArchivalUser - 11-29-2007
it sounds like cushing to me as there is not much diurnal variation in cortisol in am and pm
0 - ArchivalUser - 11-29-2007
thanx
more relpys please
0 - ArchivalUser - 11-29-2007
the normal diurnal variation is
-under ACTH influence
-Highest cortisol in early am
-Lowest cortisol in late pm
In this case low in am and high in pm
Glucocorticoid excess causes cutaneous striae
Glucose is normal
your medical school stay late craming books , stressed and increase his ACTH and Corticol
Stress related cushing's syndrome.
0 - ArchivalUser - 11-29-2007
I mean med school student
sorry 4 typo
0 - ArchivalUser - 11-29-2007
thanx okt3 for ur opinion
so how we mange this case?