Journal of Obesity & Metabolic Syndrome



Korean J Obes 2011; 20(4): 219-221

Published online December 1, 2011

Copyright © Korean Society for the Study of Obesity.

Cushing’s Disease in an Obese Patient Accompanied by Recurrent Urinary Tract Infection and Nephrolithiasis

Seonghyup Hyun, Jae Woong Kim, Moon Ki Hong, Mi Yi Kim,Seung Eun Lee, Seok Hong Lee, Jaetaek Kim, Jihyun Ahn*

Department of Internal Medicine, College of Medicine, Chung-Ang University

Cushing’s disease can cause obesity, diabetes and hypertension. Nephrolithiasis is prevalent in obese population. A variety of factors influence the formation of nephrolithiasis such as gender, diet, and urinary excretion of calcium, oxalate, and uric acid. We report a case of Cushing’s disease in an obese diabetic patient accompanied by recurrent urinary tract infection and nephrolithiasis. After the removal of pituitary tumor, diabetes and urinary tract infection were completely remitted.

Keywords: Cushing disease, Obesity, Nephrolithiasis

Fig. 1. Abdominal CT scan shows a large staghorn stone in right kidney and perinephric fat infiltration which is compatible for pyelonephritis.
Fig. 2. Sella MR shows 9 × 6.5 mm sized microadenoma in right wing of pituitary gland without cavernous sinus involvement.
  1. Faggiano A, Pivonello R, Melis D, Filippella M, Di Somma C, Petretta M, et al. Nephrolithiasis in Cushing’s disease: prevalence, etiopathogenesis, modification after disease cure. J Clin Endocrinol Metab 2003;88:2076-80.
    Pubmed CrossRef
  2. Hahn TJ, Halstead LR, Teitelbaum SL, Hahn BH. Altered mineral metabolism in glucocorticoid-induced osteopenia. Effect of 25-hydroxyvitamin D administration. J Clin Invest 1979;64:655-65.
    Pubmed KoreaMed CrossRef
  3. Curhan GC, Willett WC, Rimm EB, Speizer FE, Stampfer MJ. Body size and risk of kidney stones. J Am Soc Nephrol 1998;9:1645-52.
  4. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, the risk of kidney stones. JAMA 2005;293:455-62.
    Pubmed CrossRef
  5. Ekeruo WO, Tan YH, Young MD, Dahm P, Maloney ME, Mathias BJ, et al. Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol 2004;172:159-63.
    Pubmed CrossRef
  6. Taylor EN, Curhan GC. Body size and 24-hour urine composition. Am J Kidney Dis 2006;48:905-15.
    Pubmed CrossRef
  7. Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT. Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int 1979;16:624-31.
    Pubmed CrossRef
  8. Serio A, Fraioli A. Epidemiology of nephrolithiasis. Nephron 1999;81 Suppl 1:26-30.
    Pubmed CrossRef
  9. Canalis E. Mechanisms of glucocorticoid action in bone: implications to glucocorticoid-induced osteoporosis. J Clin Endocrinol Metab 1996;81:3441-7.
    Pubmed CrossRef
  10. Aytug S, Laws ER, Vance ML. The utility of the high dose dexamethasone suppression test in confirming the diagnosis of Cushing's disease. Endocr Pract Epub ahead of print 2011.