Case 4 Endocrinology Part 2

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A. Expanded Database - Diagnostic Test Results

1 Test / Procedure: LDDS
Results:

pre-cortisol: 152 nmol/L (28-110 nmol/L); 8-hour post: 135 nmol/L (<28 nmol/L)

Review indications & protocol in notes.

What is your assessment?

2 Test / Procedure: HDDS
Results:

Pre cortisol: 147 nmol/l (28-110 nmol/l): 8 hr Post: 31 nmol/l (50% or greater suppression)

Review indications & protocol in notes.

What is your assessment?

3 Test / Procedure: Urine culture
Results:

Staphylococcus intermedius (>100,000/ml)

Review indications & protocol in notes.

What is your assessment?

4 Test / Procedure: Total T-4
Results:

3.5 ng/ml (5-22 ng/ml)

Review indications & protocol in notes.

What is your assessment?

5 Test / Procedure: Free T-4 (fT4)
Results:

0.5 ng/dl (0.3-2.0 ng/dl)

Review indications & protocol in notes.

What is your assessment?

B. Final Diagnosis

C. Therapeutic Plan

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To view other dermatological manifestations of hyperadrenocorticism, click on the image at right.