ArticleEndocrinology, diabetes & metabolism case reports2015
Fluconazole and acetazolamide in the treatment of ectopic Cushing's syndrome with severe metabolic alkalosis.
Article in Endocrinology, diabetes & metabolism case reports, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Clinical efficacy and safety of fluconazole treatment in patients with Cushing's syndrome.Therapeutic advances in endocrinology and metabolism · 2025Article
- Fluconazole for Hypercortisolism in Cushing's Disease: A Case Report and Literature Review.Frontiers in endocrinology · 2020Article
- [Austrian Consensus on High Blood Pressure 2019].Wiener klinische Wochenschrift · 2019Article
- Fluconazole treatment in severe ectopic Cushing syndromeEndocrinology, diabetes & metabolism case reports · 2019Article
- Clinical-Pathological Conference Series from the Medical University of Graz : Case No 160: 33-year-old woman with tetraparesis on Easter Sunday.Wiener klinische Wochenschrift · 2016Article
- Review
- Fluconazole in the treatment of Cushing's disease.Endocrinology, diabetes & metabolism case reports · 2016Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledCushing's syndrome (CS) due to ectopic ACTH production accounts for about 10% of all types of CS and is frequently associated with metabolic alkalosis. Treatment of CS involves surgical resection and/or medical therapy to control hypercortisolism. We present the case of an 80-year-old woman affected by CS due to an unknown cause. The patient had severe metabolic alkalosis with refractory hypokalemia. To treat the underlying CS, fluconazole was initiated due to unavailability of ketoconazole. In spite of markedly decreasing cortisol levels, metabolic alkalosis persisted. Treatment of metabolic alkalosis with acetazolamide was thus initiated and pH levels successfully lowered. This case report shows that hypercortisolism can be effectively treated with fluconazole in cases where ketoconazole is unavailable or not tolerated and that persistent severe metabolic alkalosis caused by glucocorticoid excess can be safely and successfully treated with acetazolamide. LEARNING POINTS: Hypercortisolism can be effectively treated with fluconazole where ketoconazole is unavailable or not tolerated.Glucocorticoid excess can cause severe metabolic alkalosis.Persistent severe metabolic alkalosis can be safely and successfully treated with acetazolamide.
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