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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Ogata, Tsutomu / Toppari, Jorma

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Volume 26, Issue 9-10

Issues

Cushing syndrome related to leukemic infiltration of the central nervous system: a case report and a possible role of LIF

Nursel Muratoglu Sahin
  • Corresponding author
  • Department of Pediatric Endocrinology, School of Medicine, Baskent University, Fevzi Cakmak Cad. 10. Sokak No: 45, 06490 Bahcelievler, Ankara, Turkey
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/ Zekai Avci / Baris Malbora / Ayhan Abaci / Sibel Tulgar Kinik / Namik Yasar Ozbek
Published Online: 2013-05-17 | DOI: https://doi.org/10.1515/jpem-2012-0401

Abstract

Background: Adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome (CS) in the presence of leukemic central nervous system infiltration is very rare.

Case: A 3.8-year-old girl who had been treated for B-cell acute lymphoblastic leukemia (ALL) for 1.5 years was admitted to our hospital with excessive weight gain and depression for the last 2 months. Prior to her admission, she was on maintenance with the ALL-BFM95 study protocol for 10 months that does not contain corticosteroids. On physical examination, central obesity and moon face appearance were determined. Laboratory tests revealed high morning ACTH, cortisol level, and 24-h urinary free cortisol level. Morning cortisol level was 33.94 nmol/L after a 2-day (4×0.5 mg) dexamethasone suppression test. A lumbar puncture revealed leukemic cells in the cerebrospinal fluid. No pituitary adenoma was detected on magnetic resonance imaging. We diagnosed the patient with ACTH-dependent CS related to leukemic infiltration of the central nervous system.

Conclusion: Central nervous system infiltration should be considered in leukemic patients who have developed CS. We believe increased leukemia inhibitory factor levels may be a factor for CS in our patient with ALL.

Keywords: acute lymphoblastic leukemia (ALL); Cushing syndrome; leukemic central nervous system infiltration; leukemia inhibitory factor (LIF)

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About the article

Corresponding author: Nursel Muratoglu Sahin, Department of Pediatric Endocrinology, School of Medicine, Baskent University, Fevzi Cakmak Cad. 10. Sokak No: 45, 06490 Bahcelievler, Ankara, Turkey, Phone: +90-312-215-21-14, Fax: +90-312-215-75-97, E-mail:


Received: 2012-12-14

Accepted: 2013-04-01

Published Online: 2013-05-17

Published in Print: 2013-10-01


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 26, Issue 9-10, Pages 967–970, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2012-0401.

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