Two Diagnoses Become One? Rare Case Report of Anorexia Nervosa and Cushing’s Syndrome
March 2013
in “
Neuropsychiatric Disease and Treatment
”
Cushing's syndrome anorexia nervosa hyperandrogenism hyperandrogenemia osteoporosis secondary amenorrhea adrenal tumor laparoscopic adrenalectomy hormonal disturbances estrogen replacement oral contraceptives cortisol bone loss menstrual function Cushing's anorexia high cortisol bone thinning missed periods adrenal gland tumor keyhole surgery hormone therapy birth control pills stress hormone bone health periods
TLDR A woman with anorexia and Cushing's syndrome improved after tumor removal, highlighting the need to consider hormonal issues in psychiatric conditions.
In the 2013 case report, a 26-year-old female with anorexia nervosa, depression, and paranoid schizophrenia was diagnosed with Cushing's syndrome, marked by symptoms overlapping with her eating disorder, including hypercortisolemia, osteoporosis, and secondary amenorrhea. A 27 mm adrenal tumor was found and removed via laparoscopic adrenalectomy, leading to significant post-surgery improvements: cessation of eating and mood disorders, return of her menstrual cycle, and a normal body mass index of 23 kg/m². The case illustrates the diagnostic challenges in distinguishing between anorexia nervosa and Cushing's syndrome due to symptom overlap and underscores the importance of considering hormonal disturbances in psychiatric conditions. The document also discusses the ineffectiveness of estrogen replacement or oral contraceptives in treating anorexia-related osteoporosis, suggesting a role of cortisol in bone loss, and calls for further research into the connections between hypercortisolemia, depression, bone health, and menstrual function.
