Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome

Nobumasa Ohara; Masanori Kaneko; Kazuhiro Sato; Hiroyuki Usuda; Junta Tanaka; Takashi Maekawa; Hironobu Sasano; Hideki Katakami; Kenzo Kaneko; Kyuzi Kamoi

doi:10.2169/internalmedicine.55.5566

CASE REPORTS

Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome

Nobumasa Ohara, Masanori Kaneko, Kazuhiro Sato, Hiroyuki Usuda, Junta Tanaka, Takashi Maekawa, Hironobu Sasano, Hideki Katakami, Kenzo Kaneko, Kyuzi Kamoi

Author information

Nobumasa Ohara
Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, Japan
Department of Endocrinology and Metabolism, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
Masanori Kaneko
Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, Japan
Kazuhiro Sato
Department of Respiratory Medicine, Nagaoka Red Cross Hospital, Japan
Hiroyuki Usuda
Department of Pathology, Nagaoka Red Cross Hospital, Japan
Junta Tanaka
Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Japan
Takashi Maekawa
Department of Pathology, Tohoku University School of Medicine, Japan
Hironobu Sasano
Department of Pathology, Tohoku University School of Medicine, Japan
Hideki Katakami
Division of Clinical Research Sciences, Department of Medicine, Teikyo University Chiba Medical Center, Japan
Kenzo Kaneko
Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, Japan
Kyuzi Kamoi
Center of Diabetes, Endocrinology and Metabolism, Joetsu General Hospital, Japan

Keywords: idiopathic pulmonary fibrosis, acute exacerbation, small cell lung carcinoma, ectopic Cushing's syndrome, adrenal inhibitor

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 4 Pages 389-394

DOI https://doi.org/10.2169/internalmedicine.55.5566

Details

Abstract

A 64-year-old Japanese man with mild reticular shadows in both lungs developed a lung tumor causing ectopic Cushing's syndrome. He was prescribed an adrenal inhibitor, which controlled his hypercortisolemia. However, he developed acute exacerbation of idiopathic pulmonary fibrosis (IPF) and died within weeks. Previous studies have suggested a dosage reduction of corticosteroids for IPF as a triggering event for acute exacerbation. The present case suggests that IPF coexisting with Cushing's syndrome may have been exacerbated after the correction of hypercortisolemia. Therefore, close monitoring of cortisol levels along with the clinical course of IPF is required in similar cases that require the correction of hypercortisolemia.

Corresponding author

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