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"documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2022;158:397-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Birt–Hogg–Dubé syndrome: Clinical and genetic characterization" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "397" "paginaFinal" => "398" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Birt-Hogg-Dubé: caracterización clínica y genética" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1902 "Ancho" => 900 "Tamanyo" => 224895 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a: cutaneous papules in the face; b: multiple bilateral pulmonary cysts; c: right renal tumour.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mario Virgilio Di Campli, Maria Vall, Joan Ramón Badia" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Mario Virgilio" "apellidos" => "Di Campli" ] 1 => array:2 [ "nombre" => "Maria" "apellidos" => "Vall" ] 2 => array:2 [ "nombre" => "Joan Ramón" "apellidos" => "Badia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775321005169" "doi" => "10.1016/j.medcli.2021.07.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775321005169?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622001474?idApp=UINPBA00004N" "url" => "/23870206/0000015800000008/v1_202205170713/S2387020622001474/v1_202205170713/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Cushing disease" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "399" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "María Carrera-Morodo, Andrea Larrañaga Cabrera" "autores" => array:2 [ 0 => array:4 [ "nombre" => "María" "apellidos" => "Carrera-Morodo" "email" => array:1 [ 0 => "mcmorodo@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Andrea" "apellidos" => "Larrañaga Cabrera" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Centro de Salud La Marina, SAP Esquerra Barcelona, Institut Catalá de la Salut, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad de Cushing" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1294 "Ancho" => 1300 "Tamanyo" => 212991 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cushing’s disease phenotype.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 43-year-old woman diagnosed with high blood pressure and non-insulin-dependent type 2 diabetes mellitus sought medical advice by telephone due to a 3-month history of weight gain and abdominal obesity, a tendency to hypertension, metrorrhagia and wound-healing difficulties. In the context of the COVID-19 pandemic, blood tests were requested and confirmed a worsening of glycaemic control. One year later, the patient complained of palpitations and pain in the right leg. Examination revealed fat accumulation in the bitemporal and supraclavicular regions, hirsutism, facial hyperpigmentation, and thinning of the lower limbs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A CBC was requested with 24-h urinary free cortisol (341.8<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h, NV 12.8–82.5<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h), suppression with 1<span class="elsevierStyleHsp" style=""></span>mg dexamethasone (9.21<span class="elsevierStyleHsp" style=""></span>μg/dL, NV<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>1.8<span class="elsevierStyleHsp" style=""></span>μg/dL) and adrenocorticotropic hormone (ACTH) determination (97<span class="elsevierStyleHsp" style=""></span>pg/mL, NV 10–60<span class="elsevierStyleHsp" style=""></span>pg/dL) confirmed the diagnosis of endogenous ACTH-dependent Cushing's syndrome. Cranial magnetic resonance imaging (MRI) showed a thickening of the pituitary gland, with heterogeneous enhancement and a cystic area inside of 1.5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>mm, which led to a diagnosis of Cushing’s disease.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Carrera-Morodo M, Larrañaga Cabrera A. Enfermedad de Cushing. Med Clin (Barc). 2022;158:399.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1294 "Ancho" => 1300 "Tamanyo" => 212991 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cushing’s disease phenotype.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015800000008/v1_202205170713/S2387020622001528/v1_202205170713/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015800000008/v1_202205170713/S2387020622001528/v1_202205170713/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622001528?idApp=UINPBA00004N" ]
