Resumo

SOTELO-CRUZ, Norberto et al. Cortical adrenal adenoma, hypercortisolism, cardiomyopathy, and intra-pancreatic accessory spleen in a 3-month-old infant. Bol. Med. Hosp. Infant. Mex. [online]. 2009, vol.66, n.3, pp.265-272. ISSN 1665-1146.

Introduction. Cushing syndrome is associated with high levels of glucocorticoids in the circulation and is infrequently in infants. Case report. We present a case of congenital cortical adrenal adenoma-associated endogenous hypercortisolism in a 3-month-old infant. The patient manifested polyphagia, weight gain, and changes in sleep patterns. During physical examination we found a full-moon face, bulkiness in the cervico-dorsal "buffalo-hump" region, high blood pressure, and serum cortisol of 163 pg/dL. Abdominal ultrasound revealed left adrenal tumor. During hospitalization, the patient experienced respiratory difficulty and tachycardia, and thoracic X- ray revealed cardiomegaly. After a simple surgical procedure (venous dissection), the patient developed cardiogenic shock and died. At autopsy, adrenal tumor was found in addition to hypertrophic cardiomyopathy and intrapancreatic accessory spleen. Conclusion. The most common cause of Cushing syndrome in all age groups is exogenous hypercortisolism, except in infants. The associated pathologies described in this article are rare.

Palavras-chave : Adrenal cortical; adenoma; adrenal gland hyperfunction; hypercortisolism; cardiopathy; hypertrophic; spleen; intrapancreatic accessory.

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