Melola Discovery

← Melola Discovery

Jurnal SINTA 1

Cushing’s syndrome manifesting as chronic insomnia caused by adrenal cortical adenoma with incidental pituitary microadenoma: a case report

Journal of Biomedicine and Translational Research · Vol. 7 No. 1 (2021) · hlm. 22–26

DOI
10.14710/jbtr.v7i1.9247
ISSN
2503-2178
Terbit
2021-04-30
Penerbit
Faculty of Medicine, Universitas Diponegoro
Bahasa
eng

Abstrak

Background: Cushing’s syndrome is condition caused by excessive glucocorticoid with insomnia as one of its neuropsychiatric manifestation. Cushing’s syndrome may be caused by excessive adrenocorticotropin hormone (ACTH-dependent), for example from ACTH producing pituitary tumors, or by overproduction of cortisol by adrenocortical tumors. In this report, we presented a case with Cushing’s syndrome manifesting as chronic insomnia with adrenal cortical adenoma and pituitary microadenoma.Case presentation: A 30-year-old woman was consulted from the Neurologic Department to the Internal Medicine Department with the chief complaint of insomnia and worsening headache since 6 months prior to the admission. She had undergone head MRI and abdominal CT scan previously and was found to have both pituitary microadenoma and left adrenal mass. From the physical examination she had clinical signs of Cushing’s syndrome like Cushingoid face and purplish striae on her stomach. Midnight cortisol serum examination was done initially and showed high level of cortisol. High dose dexamethasone suppression test or DST (8 mg overnight) was later performed to help determine the main cause of Cushing’s syndrome. The result failed to reach 50% suppression of cortisol serum, suggestive that the Cushing’s syndrome was not ACTH-dependent from the pituitary but potentially from overproduction of cortisol by the left adrenal mass. Therefore, left adrenalectomy was performed and the histopathological study supported the diagnosis of adrenal cortical adenoma.Conclusion: Chronic insomnia is a very important symptoms of Cushing’s syndrome that should not be neglected. The patient had both microadenoma pituitary and left adrenal mass thus high dose DST test (8 mg overnight) needed to be performed to differentiate the source of Cushing’s syndrome. The result showed only little suppression therefore the pituitary microadenoma was not the source of Cushing’s syndrome and more suggestive from the adrenal etiology.

Kata kunci

Jaringan kolaborasi para penulis

17 penulis · 40 tautan kepenulisan bersama · 9 lintas organisasi

Arahkan kursor atau ketuk sebuah nama untuk menyorot rekan penulisnya. Klik dua kali untuk membuka halaman penulis.

  • Diponegoro University
  • Dr. Kariadi Hospital
  • Organisasi berbeda
  • Organisasi sama
  • Afiliasi tidak diketahui
  • Garis lebih tebal = lebih banyak artikel bersama · lingkaran lebih besar = lebih banyak artikel
Tampilkan sebagai tabel
Rekan penulisOrganisasiArtikel bersama
Kanti YunikaDiponegoro University1
Sari Nafa HerlinaDiponegoro University1
Mohammad SulchanDiponegoro University1
Natalia Dewi WardaniDiponegoro University1
Tanjung Ayu SumekarDiponegoro University1
Innawati JusupDiponegoro University1
Titis HadiatiDiponegoro University1
Muhammad Hussein GasemDiponegoro University1
Purnomo HadiDiponegoro University1
Sri Padma SariDiponegoro University1
Widodo SarjanaDiponegoro University1

Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.

Sumber metadata: OAI-PMH (metadata jurnal) https://ejournal2.undip.ac.id/index.php/jbtr/oai, pertama di-harvest 9 Nov 2026, terakhir terlihat 9 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Cushing’s syndrome manifesting as chronic insomnia caused by adrenal cortical adenoma with incidental pituitary microadenoma: a case report</dc:title>
	<dc:creator>Rakhmayanti, Rizky</dc:creator>
	<dc:creator>Minuljo, Tania Tedjo</dc:creator>
	<dc:creator>Suryawati, Herlina</dc:creator>
	<dc:creator>Fitrikasari, Alifiati</dc:creator>
	<dc:creator>Soedarso, Mohamad Adi</dc:creator>
	<dc:creator>Priambada, Dody</dc:creator>
	<dc:subject xml:lang="en-US">Cushing’s syndrome; insomnia; adrenal cortical adenoma; pituitary microadenoma; dexamethasone suppression test</dc:subject>
	<dc:description xml:lang="en-US">Background: Cushing’s syndrome is condition caused by excessive glucocorticoid with insomnia as one of its neuropsychiatric manifestation. Cushing’s syndrome may be caused by excessive adrenocorticotropin hormone (ACTH-dependent), for example from ACTH producing pituitary tumors, or by overproduction of cortisol by adrenocortical tumors. In this report, we presented a case with Cushing’s syndrome manifesting as chronic insomnia with adrenal cortical adenoma and pituitary microadenoma.Case presentation: A 30-year-old woman was consulted from the Neurologic Department to the Internal Medicine Department with the chief complaint of insomnia and worsening headache since 6 months prior to the admission. She had undergone head MRI and abdominal CT scan previously and was found to have both pituitary microadenoma and left adrenal mass. From the physical examination she had clinical signs of Cushing’s syndrome like Cushingoid face and purplish striae on her stomach. Midnight cortisol serum examination was done initially and showed high level of cortisol. High dose dexamethasone suppression test or DST (8 mg overnight) was later performed to help determine the main cause of Cushing’s syndrome. The result failed to reach 50% suppression of cortisol serum, suggestive that the Cushing’s syndrome was not ACTH-dependent from the pituitary but potentially from overproduction of cortisol by the left adrenal mass. Therefore, left adrenalectomy was performed and the histopathological study supported the diagnosis of adrenal cortical adenoma.Conclusion: Chronic insomnia is a very important symptoms of Cushing’s syndrome that should not be neglected. The patient had both microadenoma pituitary and left adrenal mass thus high dose DST test (8 mg overnight) needed to be performed to differentiate the source of Cushing’s syndrome. The result showed only little suppression therefore the pituitary microadenoma was not the source of Cushing’s syndrome and more suggestive from the adrenal etiology.</dc:description>
	<dc:publisher xml:lang="en-US">Faculty of Medicine, Universitas Diponegoro</dc:publisher>
	<dc:date>2021-04-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US"></dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://ejournal2.undip.ac.id/index.php/jbtr/article/view/9247</dc:identifier>
	<dc:identifier>10.14710/jbtr.v7i1.9247</dc:identifier>
	<dc:source xml:lang="en-US">Journal of Biomedicine and Translational Research; Vol 7, No 1 (2021): April 2021; 22-26</dc:source>
	<dc:source>2503-2178</dc:source>
	<dc:source>10.14710/jbtr.v7i1</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://ejournal2.undip.ac.id/index.php/jbtr/article/view/9247/5440</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2021 Journal of Biomedicine and Translational Research</dc:rights>
</oai_dc:dc>