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A 69-year-old woman was diagnosed with an adrenocorticotropic hormone (ACTH)-producing pituitary microadenoma. She underwent transsphenoidal surgery in 2009, but her hypercortisolism had only a mild improvement. After refusing bilateral adrenalectomy and radiotherapy, she was started on oral ketoconazole 600 mg/day. A month later, her urinary free cortisol decreased to 54 ìg/24 hours and there was a mild clinical improvement. Osteoporosis was revealed on a dual-energy x-ray absorptiometry (DEXA) scan with a T score of –2.5 in the lumbar spine and –3.2 in femoral neck; however, we should consider that compression fractures may falsely increase bone mineral density. Bone mass was persistently low despite aggressive treatment with zoledronic acid, raloxifene, calcitriol, and calcium carbonate.

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2017-05-23   |   220 visitas   |   Evalua este artículo 0 valoraciones

Vol. 3 Núm.3. Julio-Septiembre 2016 Pags. 149-150 Rev Mex Endocrinol Metabol Nut 2016; 3(3)