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Primary Generalized Glucocorticoid Hypersensitivity Treated with Mifepristone: A Case Report

Authors Liu Y, Han M, Yang J, Xu Q, Xu L, Ren Y, Xiang C, Liu Z, Zhang Y

Received 25 July 2020

Accepted for publication 17 September 2020

Published 13 October 2020 Volume 2020:13 Pages 825—831

DOI https://doi.org/10.2147/IJGM.S273969

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Yunfeng Liu,1 Minmin Han,1,2 Jing Yang,1 Qishan Xu,1 Linxi Xu,1 Yi Ren,1 Chenyu Xiang,1 Zi’ang Liu,2 Yi Zhang3

1Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan 03000, China; 2First Clinical Medical College, Shanxi Medical University, Taiyuan 03000, China; 3Department of Pharmacology, Shanxi Medical University, Taiyuan 03000 China

Correspondence: Yunfeng Liu
Department of Endocrinology, First Hospital of Shanxi Medical University, No. 85, Jiefang Nan Road, Yingze District, Taiyuan City, Shanxi Province 03000, China
Tel +86-18703416196
Fax +86-0351-4639769
Email nectarliu@163.com

Abstract: Here, we report a case of a patient with symptoms of Cushing syndrome, who is diagnosed with primary generalized glucocorticoid hypersensitivity in the end. The patient’s relevant laboratory tests and imaging examinations are described. Mifepristone, a glucocorticoid receptor antagonist, was prescribed and its therapeutic effect on the patient’s electrolyte level, lipid metabolism, and bone metabolism was observed during the treatment. The endocrine assessment indicated normal pituitary-adrenal axis regulation function but reduced cortisol secretion. Quantitative reverse transcription-polymerase chain reaction indicated reduced mRNA level of mineralocorticoid receptor gene. Pituitary magnetic resonance imaging showed normal pituitary anatomy, while adrenal computed tomography scan showed bilateral adrenal atrophy and increased content of visceral and abdominal subcutaneous fat. Moreover, chromosome examination revealed a normal 46, XY chromosome. In this case, mifepristone was administered to treat primary generalized glucocorticoid hypersensitivity. To the best of our knowledge, there are a few reports on mifepristone-treated primary generalized glucocorticoid hypersensitivity. In the one-year follow-up visits, the evaluated results of electrolyte level, lipid metabolism, and bone metabolism indicated that the patient’s symptoms resulting from cortisol hypersensitivity were relieved progressively.

Keywords: primary generalized glucocorticoid hypersensitivity, mifepristone, glucocorticoid receptor, electrolyte, lipid metabolism, bone metabolism

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