EP197 - ECE_1768 - Effective cortisol synthesis control with markedly low-dose osilodrostat in ACTH-independent Cushing syndrome: a case report
Abstract
Surgical adrenalectomy is the treatment of choice in ACTH-independent Cushing syndrome (CS). However, it may be contraindicated in patients with advanced age or severe comorbidities. Pharmacological treatment options include osilodrostat, an oral 11β-hydroxylase inhibitor approved for ACTH-dependent CS, which has been used sporadically in ACTH-independent CS. We present a case of ACTH-independent CS successfully controlled with extremely low doses of osilodrostat.
A 64-year-old female was admitted to the endocrinology unit for evaluation of resistant hypertension with persistent hypokalemia. The initial evaluation suggested primary aldosteronism, but subsequent hormonal work-up established ACTH-independent CS, with elevated 24-hour urinary free cortisol, loss of the diurnal cortisol rhythm, unresponsiveness to 1 mg overnight dexamethasone suppression test, and decreased plasma ACTH level. Abdominal CT imaging revealed a 17-mm adrenal tumour of the right gland with benign radiological features. The patient presented with multiple, potentially CS-related comorbidities, including obesity (BMI 35.7 kg/m²), type 2 diabetes mellitus, severe hypertension with kidney disease, osteoporosis (with low-trauma vertebral fractures), and severe obstructive sleep apnea. Her medical history was complicated by life-threatening infections, including severe COVID-19 pneumonia requiring ICU admission (2020) and septic shock in the course of necrotizing soft tissue infection of the lower…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Propranolol, chlorpromazine and diclofenac restore susceptibility of extensively drug-resistant (XDR)-Acinetobacter baumannii to fluoroquinolones
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.