Posterior reversible encephalopathy syndrome postpartum

Preeclampsia (PE) should be considered in women with headache who are in gestational week 20 or more, are in labor, or have recently given birth. Early diagnosis is essential to arrest disease progression and further prognosis in PE.     

Small cell lung cancer with panhypopituitarism due to ectopic adrenocorticotropic hormone syndrome: A case report

BACKGROUND Small cell lung cancer(SCLC)accounts for 15%of lung cancers,and it commonly expresses peptide and protein factors that are active as hormones.These secreting factors manifest as paraneoplastic disorders,such as ectopic adrenocorticotropic hormone(ACTH)syndrome(EAS).The clinical features are abnormalities in carbohydrate metabolism,hypokalemia,peripheral edema,proximal myopathy,hypertension,hyperpigmentation,and severe systemic infection.However,it is uncommon that EAS has an influence on hypothalamus-pituitary function.CASE SUMMARY A 62-year-old man presented with complaints of haemoptysis,polyuria,polydipsia,increased appetite,weight loss,and pigmentation.Following a series of laboratory and imaging examinations,he was diagnosed with SCLC,EAS,hypogonadism,hypothyroidism,and central diabetes insipidus.After three rounds of chemotherapy,levels of ACTH,cortisol,thyroid hormone,gonadal hormone,and urine volume had returned to normal levels.In addition,the pulmonary tumor was reduced in size.CONCLUSION We report a rare case of SCLC complicated with panhypopituitarism due to EAS.We hypothesize that EAS induced high levels of serum glucocorticoid and negative feedback for the synthesis and secretion of antidiuretic hormone from the paraventricular nucleus,and trophic hormones from the anterior pituitary.Therefore,patients who present with symptoms of hypopituitarism,or even panhypopituitarism,with SCLC should be evaluated for EAS.     

Adrenal and hypophyseal non-Hodgkin's lymphoma presenting with panhypopituitarism

We report a case of non-Hodgkin's lymphoma presenting as anterior pituitary failure and found to have involvement of two endocrine glands, the pituitary and the adrenals.     

Strongyloides hyperinfection syndrome complicating (ectopic) Cushing syndrome

Strongyloidiasis can present with a wide variety of symptoms and can lead to a potentially fatal hyperinfection. Although any factors that suppress the host defense mechanisms can potentially trigger hyperinfection, prolonged steroid use has been quite well described. A patient with disseminated small cell lung cancer suffered a Strongyloides stercoralis hyperinfection syndrome complicating ectopic adrenocorticotropic hormone (Cushing syndrome). Evaluation revealed lymphopenia, elevated levels of adrenocorticotropic hormone in the setting of elevated cortisol levels, a normal pituitary, and metastatic malignancy. S. stercoralis larval forms were seen in the stool and sputum. At autopsy, S. stercoralis larval forms were seen in the lung along with evidence of metastatic small cell lung carcinoma.     

Paraproteinemia in patients with acquired immunodeficiency syndrome (AIDS) or lymphadenopathy syndrome (LAS)

Eight of 15 patients with acquired immunodeficiency syndrome (AIDS) and six of nine patients with lymphadenopathy syndrome (LAS) had paraproteins in their sera. Twelve of these 14 were IgG kappa; the other two had no demonstrable light chains. The relationship of the paraprotein to the pathogenesis of AIDS is not clear, but we discuss its relation to derangements of B-cell immune regulation and function and to B-cell tumors in AIDS patients.