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A woman who gained weight and became schizophrenic
| Content Provider | Semantic Scholar |
|---|---|
| Author | Zielasek, Jürgen Bender, Gwendolyn Schlesinger, Stefan Friedl, Peter Lauer, Martin |
| Copyright Year | 2002 |
| Abstract | Over 6 years, a 45-year old woman developed persecutory ideas, social withdrawal, self-neglect, and a thought disorder. Some months before her admission to our hospital in October, 2000, a psychiatrist noticed obesity and bruises on her forearms. She refused to cooperate with diagnostic procedures or treatment, and had to be put in the care of a legal guardian. When she came to our clinic, she was disoriented, depressed, lacked initiative, but denied being ill. Her attention span and memory were poor, she thought slowly, had false reasoning with a lack of consistency, and persecutory ideas without hallucinations. She had Cushingoid features with obesity (body-mass index 29), moon face, buffalo hump, skin atrophy, and hypertension, BP 160/110 mm Hg. Blood tests showed macrocytosis and decreased serum vitamin B12 at 159 pg/mL. Vitamin B12 injections and flupentixol had no effect on her mental state. A cranial magnetic resonance image and a lumbar spinal fluid analysis including angiotensin converting enzyme were normal. Urinary free cortisol excretion was elevated to 148·8 µg/day. Serum cortisol showed attenuated circadian rhythm (0800 h 22·6 µg/dL, 2400 h 9·8 µg/dL) and was not suppressed after 1 mg dexamethasone (baseline 14·3 µg/dL, after dexamethasone 19·5 µg/dL). Administration of corticotropin-releasing hormone (CRH) showed suppressed plasma ACTH not responding to CRH. A diagnosis of Cushing’s syndrome was made. An abdominal magnetic resonance tomogram showed a left adrenal mass, diameter 3·5 cm. Treatment with |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/S0140-6736(02)11404-8 |
| Volume Number | 360 |
| Alternate Webpage(s) | https://api.elsevier.com/content/article/pii/S0140673602114048 |
| Alternate Webpage(s) | https://www.sciencedirect.com/science/article/pii/S0140673602114048?dgcid=api_sd_search-api-endpoint |
| Alternate Webpage(s) | https://doi.org/10.1016/S0140-6736%2802%2911404-8 |
| Journal | The Lancet |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
