Pancreatic Neuroendocrine Tumor Presenting as a CushingÂ’s Syndrome Associated with HypertensionChinedu Ivonye*, Ebere Okeke, Rohan Mankikar and Jolene Lowery
Department of Medicine, Morehouse School of Medicine, Atlanta, USA
- *Corresponding Author:
- Chinedu Ivonye
Associate Professor of Medicine
Morehouse School of Medicine
720 Westview drive SW Atlanta, GA 30310, USA
Tel: 01 404 510 9919
Fax: 01 404 616 6201
E-mail: [email protected]
Received Date: November 28, 2013; Accepted Date: January 20, 2014; Published Date: January 22, 2014
Citation: Ivonye C, Okeke E, Mankikar R, Lowery J (2014) Pancreatic Neuroendocrine Tumor Presenting as a Cushing’s Syndrome Associated with Hypertension. J Hypertens 3:132. doi:10.4172/2167-1095.1000132
Copyright: © 2014 Ivonye C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A young female was evaluated in the emergency department (ED) for persistent headache and fatigue one week after being started on antihypertensive therapy with poor response. Her medications were Amlodipine 10 mg daily, Hydrochlorothiazide 25 mg daily, Atenolol 100 mg daily and Hydralazine 50 mg three times daily. Further evaluation revealed cushingoid appearance, her blood pressure was 171/100 mmHg despite compliance with multiple antihypertensive therapy. Her clinical manisfestation prompted the evaluation for secondary causes of hypertension with laboratory evidence of hypokalemia, hyperglycemia, hypercortisolism with high ACTH that did not respond to low and high dose dexamethasone suppression. A splice mutation in MEN 1gene was found with the eventual diagnosis of metastatic pancreatic neuroendocrine tumor. Her turbulent course unravels how complex medical problems continue to masquerade as general medical ailments.