Journals / Turkish Journal of Internal Medicine / 2026 / Volume: 4 Special Issue

A Rare Cause of Hypokalemia: Ectopic ACTH Syndrome

Merve Tekinyıldız(University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine)0000-0002-6356-030X
Sanem Kayhan(University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine)0000-0001-7736-2681
Murat Çalapkulu(University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism)0000-0002-7445-2275
Rıdvan Özkan(University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine)0000-0002-3895-6257
İbrahim Akdağ(University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine)0000-0003-3388-2989
Pages
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Publication Date
2022-04-01
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In the current case report, we aimed to emphasize that ectopic ACTH syndrome should be kept in mind in the differential diagnosis, especially in the presence of hypokalemia accompanying hypertension and proximal muscle weakness, if the patient also has progressive weight loss.

📌 3 Key Takeaways

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Objective & Hypothesis:The most common cause of adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome is a benign ACTH-producing pituitary tumour or, less frequently, ectopic ACTH production from non-pituitary tumours.
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Key Findings & Data:Ectopic ACTH syndrome occurs more commonly in men and usually presents after 40 years.
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Conclusion & Impact:In the current case report, we aimed to emphasize that ectopic ACTH syndrome should be kept in mind in the differential diagnosis, especially in the presence of hypokalemia accompanying hypertension and proximal muscle weakness, if the patient also has progressive weight loss.
🔬Design:Case Report
📍Scope:Comprehensive Sample
⚙️Variables:Hypokalemia · ectopic ACTH syndrome · small cell lung cancer

Abstract

The most common cause of adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome is a benign ACTH-producing pituitary tumour or, less frequently, ectopic ACTH production from non-pituitary tumours. Ectopic ACTH syndrome occurs more commonly in men and usually presents after 40 years. It is most commonly associated with small cell lung cancer. Although this syndrome is associated with severe hypercortisolemia, some findings of Cushing’s syndrome, such as central obesity, may not be observed due to underlying malignant diseases. In these cases, rapid metabolic disruption, anorexia, myopathy, glucose intolerance, hypokalemic alkalosis, and hyperpigmentation accompany the patients’ clinical condition. In the current case report, we aimed to emphasize that ectopic ACTH syndrome should be kept in mind in the differential diagnosis, especially in the presence of hypokalemia accompanying hypertension and proximal muscle weakness, if the patient also has progressive weight loss.

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Cite This Article

Tekinyıldız, M., Kayhan, S., Çalapkulu, M., Özkan, R., Akdağ, İ. (2022). A Rare Cause of Hypokalemia: Ectopic ACTH Syndrome. Turkish Journal of Internal Medicine, Volume: 4 Special Issue. https://doi.org/10.46310/tjim.1078178

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References (7)

  1. Nieman LK. Cushing’s syndrome: update on signs, symptoms and biochemical screening. Eur J Endocrinol. 2015 Oct;173(4):M33-8. doi: 10.1530/EJE-15-0464.
  2. Richa CG, Saad KJ, Halabi GH, Gharios EM, Nasr FL, Merheb MT. Case-series of paraneoplastic Cushing syndrome in small-cell lung cancer. Endocrinol Diabetes Metab Case Rep. 2018 Mar 8;2018:18-0004. doi: 10.1530/EDM-18-0004.
  3. Vrkljan M, Vizner B, Zawawi A, Bekic M, Gorecan M, Grbac I. Ectopic ACTH secretion and Cushing’s syndrome. Acta Clin Croat. 2015 Dec;54(4):536-40.
  4. Jensen RT. Harrison’s Principles of Internal Medicine. 15th ed. New York: McGraw-Hill; 2001:596-7.
  5. Avcı N, Kurt E, Kazak E, Alkış N, Çubukçu E, Ölmez ÖF, Deligönül A, Evrensel T. Ectopic ACTH Syndrome in a patient with small cell lung cancer: A case report. Journal of Uludağ University Faculty of Medicine. 2013;39(3):193-5.
  6. Terzolo M, Reimondo G, Alì A, Bovio S, Daffara F, Paccotti P, Angeli A. Ectopic ACTH syndrome: molecular bases and clinical heterogeneity. Ann Oncol. 2001;12 Suppl 2:S83-7. doi: 10.1093/annonc/12.suppl_2.s83.
  7. Davi’ MV, Cosaro E, Piacentini S, Reimondo G, Albiger N, Arnaldi G, Faggiano A, Mantovani G, Fazio N, Piovesan A, Arvat E, Grimaldi F, Canu L, Mannelli M, Ambrogio AG, Pecori Giraldi F, Martini C, Lania A, Albertelli M, Ferone D, Zatelli MC, Campana D, Colao A, Scaroni C, Terzolo M, De Marinis L, Cingarlini S, Micciolo R, Francia G. Prognostic factors in ectopic Cushing’s syndrome due to neuroendocrine tumors: a multicenter study. Eur J Endocrinol. 2017 Apr;176(4):453-61. doi: 10.1530/EJE-16-0809.