Chief Cushie ~MaryO~ Posted December 18, 2007 Chief Cushie Report Share Posted December 18, 2007 http://www.eje.org/cgi/content/abstract/157/6/779 DOI: 10.1530/EJE-07-0538 European Journal of Endocrinology, Vol 157, Issue 6, 779-781 Copyright ? 2007 by Society of the European Journal of Endocrinology CASE REPORT A ?smart? type of Cushing's syndrome A J Razenberg, J W F Elte, A P Rietveld, H C T van Zaanen and M Castro Cabezas Sint Franciscus Gasthuis Rotterdam, Department of Internal Medicine, Center for Diabetes and Vascular Medicine, PO Box 10900, 3004 BA Rotterdam, The Netherlands (Correspondence should be addressed to M C Cabezas; Email: m.castrocabezas@sfg.nl) Abstract Cushing's syndrome results from lengthy and inappropriate exposure to excessive concentrations of either endogenous or exogenous glucocorticoids. This case report describes a patient with a novel type of Cushing's syndrome due to the use of party drugs. A 35-year-old woman had gained 8 kg body weight in 5 months and complained of anxiety. She showed a Cushing-like appearance and mild hypertension (blood pressure, BP 150/95 mmHg). She reported daily use of increasing doses of {gamma}-hydroxybutyric acid (GHB), a popular party drug. ACTH plasma levels were in the upper normal range (41 ng/l), with normal plasma cortisol (0.36 ?mol/l). She showed an abnormal overnight 1 mg dexamethasone suppression test (cortisol 0.38 ?mol/l). The urinary excretion of free cortisol in 24 h was also increased (0.47 ?mol/24 h). CT scanning of the abdomen showed normal adrenals. After stopping GHB intake she lost 7 kg body weight and her BP normalized (BP 135/80 mmHg). GHB is a popular party drug in the Netherlands, but it is also used as a narcotic and for the treatment of narcolepsy. We hypothesize that GHB may bind to the pituitary gland {gamma}-aminobutyric acid-B receptors leading to ACTH overproduction. Link to comment Share on other sites More sharing options...
MCF Posted December 18, 2007 Report Share Posted December 18, 2007 Holy moly; my sister became debilitated and bedridden with fatigue on Xyrem. Once I looked it up and found that it suppresses cortisol, she began a very slow taper and is much better. Link to comment Share on other sites More sharing options...
cushiemom Posted December 18, 2007 Report Share Posted December 18, 2007 Hmmm....I wonder if the use of Extasy in my wild late teens had any adverse effect on my system? Perhaps the root cause of my current medical symptoms? Link to comment Share on other sites More sharing options...
Over 2000 Posts ADDflower Posted December 18, 2007 Over 2000 Posts Report Share Posted December 18, 2007 I just don't understand what is "smart" about this. Link to comment Share on other sites More sharing options...
Member of the 1000 Post Club Xuzuthor Posted December 18, 2007 Member of the 1000 Post Club Report Share Posted December 18, 2007 I totally agree. Not sure where smart fits in. And, cushiemom, it corrected itself right away in that person's case so it is likely not your cause. Nick Link to comment Share on other sites More sharing options...
Over 2000 Posts Sylvia3 Posted December 18, 2007 Over 2000 Posts Report Share Posted December 18, 2007 Makes me wonder if I hang out with Britney, Lindsey and Paris for a while if that will get me that last sky-high I am looking for! Link to comment Share on other sites More sharing options...
Member of the 1000 Post Club maecar Posted December 19, 2007 Member of the 1000 Post Club Report Share Posted December 19, 2007 I think the "smart" refers to the type of drug that GHB is... it is a said to enhance cognitive abilities. smart drugs Link to comment Share on other sites More sharing options...
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