Abstract
Ectopic secretion of adrenocorticotropic hormone (ACTH) related Cushing's syndrome (CS) is more frequently observed than many other paraneoplastic syndromes in patients with small cell lung cancer. Suppression of the cellular immune system in these patients is severe problem for both patients and physicians. In addition, the chemotherapy has been caused to severity and higher rate of hematological toxicity. We present a case of small cell lung cancer having a very poor prognosis, with a compressed humoral and cellular immune system due to an ectopic secretion of ACTH related CS. We report a rare case of combined immunosuppression in a case with small cell lung cancer in this paper. In addition, in the light of this special case and literature, we suggest treatment strategies for small cell lung cancer patients with CS. Ektopik adrenokortikotop (ACTH) salınmasına bağlı Cushing sendromu, küçük hücreli akciğer kanserli hastalarda diğer birçok paraneoplastik sendromlara göre daha sık görülür. Bu hastalarda hücresel bağışıklık sisteminin baskılanması hem hekimler hem de hastalar için önemli bir sorundur. Ek olarak kemoterapi, bu hastalarda şiddetli ve daha yüksek oranda hematolojik toksisiteye neden olmaktadır. Biz ektopik ACTH salınması ile ilişkili Cushing sendromuna bağlı humoral ve hücresel bağışıklık sistemi baskılanmış çok kötü seyirli bir küçük hücreli akciğer vakası sunduk. Ayrıca, bu özel vaka ve literatür ışığında Cushing sendrom olan küçük hücreli akciğerli hastalar için tedavi stratejileri önerdik.
References
- Kirk LF Jr, Hash RB, Katner HP, Jones T. Cushing's disease: clinical manifestations and diagnostic evaluation. Am Fam Physician 2000;62:1119-27.
- Ilias I, Torpy DJ, Pacak K, Mullen N, Wesley RA, Nieman LK. Cushing's syndrome due to ectopic corticotropin secre- tion: twenty years' experience at the National Institutes of Health. J Clin Endocrinol Metab 2005;90:4955-62.
- Lionakis MS, Kontoyiannis DP. Glucocorticoids and inva- sive fungal infections. Lancet 2003;362:1828-38.
- Graham BS, Tucker WS Jr. Opportunistic infections in endogenous Cushing's syndrome. Ann Intern Med 1984;101:334-8.
- Bakker RC, Gallas PR, Romijn JA, Wiersinga WM. Cushing's syndrome complicated by multiple opportunistic infec- tions. J Endocrinol Invest 1998;21:329-33.
- Sarlis NJ, Chanock SJ, Nieman LK. Cortisolemic indices predict severe infections in Cushing syndrome due to ecto- pic production of adrenocorticotropin. J Clin Endocrinol Metab 2000;85:42-7.
- Shepherd FA, Laskey J, Evans WK, Goss PE, Johansen E, Khamsi F. Cushing's syndrome associated with ectopic corticotropin production and small-cell lung cancer. J Clin Oncol 1992;10:21-7.
- Dimopoulos MA, Fernandez JF, Samaan NA, Holoye PY, Vassilopoulou-Sellin R. Paraneoplastic Cushing's syndrome as an adverse prognostic factor in patients who die early with small cell lung cancer. Cancer 1992;69:66-71.
- Würzburger MI, Prelević GM, Brkić SD, Vucković S, Pendić B. Cushing's syndrome--transitory immune deficiency state? Postgrad Med J 1986;62:657-9.
- Cenci E, Perito S, Enssle KH, Mosci P, Latgé JP, Romani L, et al. Th1 and Th2 cytokines in mice with invasive aspergil- losis. Infect Immun 1997;65:564-70.
Abstract
Ektopik adrenokortikotop (ACTH) salınmasına
bağlı Cushing sendromu, küçük hücreli akciğer
kanserli hastalarda diğer birçok paraneoplastik
sendromlara göre daha sık görülür. Bu hastalarda
hücresel bağışıklık sisteminin baskılanması
hem hekimler hem de hastalar için önemli
bir sorundur. Ek olarak kemoterapi, bu hastalarda
şiddetli ve daha yüksek oranda hematolojik
toksisiteye neden olmaktadır. Biz ektopik
ACTH salınması ile ilişkili Cushing sendromuna
bağlı humoral ve hücresel bağışıklık sistemi
baskılanmış çok kötü seyirli bir küçük hücreli
akciğer vakası sunduk. Ayrıca, bu özel vaka ve
literatür ışığında Cushing sendrom olan küçük
hücreli akciğerli hastalar için tedavi stratejileri
önerdik.
References
- Kirk LF Jr, Hash RB, Katner HP, Jones T. Cushing's disease: clinical manifestations and diagnostic evaluation. Am Fam Physician 2000;62:1119-27.
- Ilias I, Torpy DJ, Pacak K, Mullen N, Wesley RA, Nieman LK. Cushing's syndrome due to ectopic corticotropin secre- tion: twenty years' experience at the National Institutes of Health. J Clin Endocrinol Metab 2005;90:4955-62.
- Lionakis MS, Kontoyiannis DP. Glucocorticoids and inva- sive fungal infections. Lancet 2003;362:1828-38.
- Graham BS, Tucker WS Jr. Opportunistic infections in endogenous Cushing's syndrome. Ann Intern Med 1984;101:334-8.
- Bakker RC, Gallas PR, Romijn JA, Wiersinga WM. Cushing's syndrome complicated by multiple opportunistic infec- tions. J Endocrinol Invest 1998;21:329-33.
- Sarlis NJ, Chanock SJ, Nieman LK. Cortisolemic indices predict severe infections in Cushing syndrome due to ecto- pic production of adrenocorticotropin. J Clin Endocrinol Metab 2000;85:42-7.
- Shepherd FA, Laskey J, Evans WK, Goss PE, Johansen E, Khamsi F. Cushing's syndrome associated with ectopic corticotropin production and small-cell lung cancer. J Clin Oncol 1992;10:21-7.
- Dimopoulos MA, Fernandez JF, Samaan NA, Holoye PY, Vassilopoulou-Sellin R. Paraneoplastic Cushing's syndrome as an adverse prognostic factor in patients who die early with small cell lung cancer. Cancer 1992;69:66-71.
- Würzburger MI, Prelević GM, Brkić SD, Vucković S, Pendić B. Cushing's syndrome--transitory immune deficiency state? Postgrad Med J 1986;62:657-9.
- Cenci E, Perito S, Enssle KH, Mosci P, Latgé JP, Romani L, et al. Th1 and Th2 cytokines in mice with invasive aspergil- losis. Infect Immun 1997;65:564-70.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | April 1, 2010 |
| Published in Issue | Year 2010 Volume: 2010 Issue: 4 |