Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access |
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc |
Journal website http://www.jofem.org |
Case Report
Volume 3, Number 1-2, April 2013, pages 29-37
Pitfalls in the Diagnosis of Ectopic Adrenocorticotropic Hormone Syndrome: A Case Report
Figures
Tables
Variable | Reference Range, Adults | Basal values |
---|---|---|
Hemogram | ||
Hemoglobin (g/dL) | 13.0 - 17.5 | 13.8 |
Hematocrit (%) | 40.0 - 50.0 | 39.4 |
Mean Cell Volume (fL) | 80.0 - 97.0 | 93.1 |
White-cell count (per µL) | 4,000 - 11,000 | 8,900 |
Neutrophils (%) | 57 - 67 | 90 |
Lymphocytes (%) | 25 - 33 | 6.5 |
Eosinophils (%) | 1-3 | 0.1 |
Platelet count (per µL) | 150,000 - 450,000 | 119,000 |
Biochemistry | ||
Glucose (mg/dL) | 70 - 110 | 288 |
Urea nitrogen (mg/dL) | 10 - 50 | 28 |
Creatinine (mg/dL) | 0.7 - 1.2 | 0.6 |
Sodium (mmol/L) | 135-145 | 150 |
Potassium (mmol/L) | 3.5 - 5.1 | 2.0 |
Chloride (mmol/L) | 98 - 107 | 96 |
Urate (mg/dL) | 200 - 420 | 136 |
Aspartate Transaminase (U/L) | 0 - 37 | 24 |
Alanine Aminotransferase (U/L) | 10 - 49 | 46 |
Gamma-glutamyl transferase (U/L) | < 73 | 21 |
Alkaline Phosphatase (U/L) | 45 - 129 | 264 |
Bilirubin (mg/dL) | 0.1 - 1.1 | 0.9 |
Proteins (g/L) | 66 - 87 | 63 |
Albumin (g/L) | 34 - 48 | 42 |
Lactate dehydrogenase (U/L) | 208 - 378 | 1,009 |
Creatine Kinase (U/L) | 32 - 294 | 55 |
Calcium (mg/dL) | 8.6 - 10.2 | 8.3 |
Phosphorus (mg/dL) | 2.7 - 4.5 | 1.5 |
Magnesium (mg/dL) | 1.6 - 2.6 | 2.1 |
Triglycerides (mg/dL) | < 200 | 164 |
Total Cholesterol (mg/dL) | < 200 | 154 |
HDL (mg/dL) | < 35 (high risk) | 44 |
C-reactive protein (mg/dL) | < 0.5 | 0.05 |
Variable | Reference Range, Adults | Basal Values |
---|---|---|
Endocrinology | ||
Insulin (mU/L) | 3 - 25 | 26.4 |
C peptide (ng/mL) | 0.8 - 3.9 | 6.16 |
Glycated haemoglobin (%) | < 6.0% | 6.3 |
Parathyroid Hormone (pg/mL) | 14 - 72 | 40.2 |
Adrenocorticotropic Hormone (pg/mL) | 0 - 46 | 212.0 |
Cortisol (µg/dL) | 4.3 - 23 (8 a.m) | 77.9 |
Hydroxyprogesterone (ng/mL) | 0.3 - 2.0 | 4.30 |
Dehydroepiandrosteronesulfate (µg/dL) | 80 - 560 | 375.0 |
Delta 4-androstenedione (ng/mL) | 0.6 - 3.1 | 16.90 |
11 Desoxycortisol - Compound S (ng/mL) | Baseline: < 7.2 | 40.30 |
Aldosterone (pg/mL) | Standing: 40 - 310 Lying: 10 - 160 | 88.4 |
Renin (pg/mL) | Standing: 2 - 50 Lying: 1.6 - 15 | 2.2 |
Thyroxin (µg/dL) | 4.5 - 10.9 | 6.6 |
Thyroid Stimulating Hormone (µU/mL) | 0.35 - 5.50 | 0.70 |
Free Thyroxin (ng/dL) | 0.89 - 1.80 | 1.20 |
Triiodothyronine (ng/mL) | 0.60 - 1.81 | 0.68 |
Follicle-stimulating hormone (U/L) | > 16 years: 1.4 - 18.1 | 0.94 |
Luteinizing Hormone (U/L) | 1.5 - 9.3 | 2.37 |
Prolactin (ng/mL) | 2.1 - 17.7 | 12.8 |
Estradiol (pg/mL) | Man: < 52 | < 10.0 |
Total Testosterone (ng/dL) | 241 - 827 | 198.0 |
Free Testosterone (pg/mL) | 8.8 - 27 | 15.30 |
Free Androgen Index | 14.8 - 94.8 | 53.8 |
Sex-hormone Binding Globulin (nmol/L) | 13 - 71 | 14.7 |
Growth Hormone (ng/mL) | 0 - 1.0 | 0.09 |
Insulin-like Growth Factor 1 (ng/mL) | 117 - 329 | 118.0 |
Tumoral markers | ||
CEA (ng/mL) | < 5.0 | 17.6 |
CA 15.3 (U/mL) | < 32 | 43.4 |
Chromogranin A (µg/L) | < 100 | 1473 |
Glycoprotein Free alpha-subunit (µg/L) | < 0.8 | 0.2 |
Calcitonin (pg/mL) | < 8.4 | < 5.00 |
Human chorionic gonadotropin (ng/mL) | 0 - 2.5 | < 0.1 |
Somatostatin (µg/L) | < 5.6 | 1.4 |
Serotonin (µg/L) | 117.5 - 193.3 | 186 |
Urinary 5-Hydroxyindoleacetic acid (mg/24h) | 0.7 - 8.2 | 12.8 |
Reference Range, Adults | Basal Values | Post- Low-Dose Dexamethasone Suppression Test | Post- High-Dose Dexamethasone Suppression Test/Pre-CRH | Post-CRH 15’ | |
---|---|---|---|---|---|
ACTH (pg/mL) | 0 - 46 | 197 | 115 | 112 | |
Cortisol (µg/dL) | 4.3 - 23 a.m. | 110 | 107 | 52 | 59 |
Urinary Cortisol (µg/24h)/Urinary Creatinine (g/24h) | 28.5 - 214/ 0.8 - 2.0 | 771 | 1,022 | 1,200 |
Inferior Petrosal Sinus Sampling with 1µg/kg endovenous CRH at 0’ | |||
---|---|---|---|
Left Inferior Petrosal Sinus | Right Inferior Petrosal Sinus | Peripheral blood | |
ACTH 0’ | 136 | 140 | 126 |
ACTH 15’ | 143 | 159 | 128 |