{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:26:27Z","timestamp":1787765187869,"version":"build-2784847793"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Subclinical Cushing\u2019s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing\u2019s disease. Infection is an important complication associated with mortality in Cushing\u2019s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-021-00757-y","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T09:21:39Z","timestamp":1619515299000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Severe infection including disseminated herpes zoster triggered by subclinical Cushing\u2019s disease: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Yuki","family":"Yamauchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1870-6688","authenticated-orcid":false,"given":"Hiraku","family":"Kameda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuno","family":"Omori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Tani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu Yong","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinobu","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Miyoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Atsumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"issue":"9996","key":"757_CR1","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1016\/S0140-6736(14)61375-1","volume":"386","author":"A Lacroix","year":"2015","unstructured":"Lacroix A, Feelders RA, Stratakis CA, Nieman LK. Cushing\u2019s syndrome. Lancet. 2015;386(9996):913\u201327.","journal-title":"Lancet"},{"issue":"6","key":"757_CR2","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1001\/archinte.161.6.892","volume":"161","author":"T Takao","year":"2001","unstructured":"Takao T, Mimoto T, Yamamoto M, Hashimoto K. Preclinical Cushing disease. Arch Intern Med. 2001;161(6):892\u20133.","journal-title":"Arch Intern Med"},{"issue":"3","key":"757_CR3","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1507\/endocrj.50.325","volume":"50","author":"K Kageyama","year":"2003","unstructured":"Kageyama K, Moriyama T, Sakihara S, Kawashima S, Suda T. A case of preclinical Cushing\u2019s disease, accompanied with thyroid papillary carcinoma and adrenal incidentaloma. Endocr J. 2003;50(3):325\u201331.","journal-title":"Endocr J"},{"issue":"5","key":"757_CR4","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/S2213-8587(13)70211-0","volume":"2","author":"G Di Dalmazi","year":"2014","unstructured":"Di Dalmazi G, Vicennati V, Garelli S, Casadio E, Rinaldi E, Giampalma E, Mosconi C, Golfieri R, Paccapelo A, Pagotto U, Pasquali R. Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing\u2019s syndrome: a 15-year retrospective study. Lancet Diabetes Endocrinol. 2014;2(5):396\u2013405.","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"43","key":"757_CR5","doi-asserted-by":"publisher","first-page":"5584","DOI":"10.2174\/1381612826666200813134328","volume":"26","author":"M Ivovi\u0107","year":"2020","unstructured":"Ivovi\u0107 M, Marina LV, \u0160ojat AS, Tan\u010di\u0107-Gaji\u0107 M, Arizanovi\u0107 Z, Kendere\u0161ki A, Vujovi\u0107 S. Approach to the patient with subclinical Cushing\u2019s syndrome. Curr Pharm Des. 2020;26(43):5584\u201390.","journal-title":"Curr Pharm Des"},{"issue":"4","key":"757_CR6","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1210\/er.2013-1048","volume":"36","author":"R Pivonello","year":"2015","unstructured":"Pivonello R, De Leo M, Cozzolino A, Colao A. The treatment of Cushing\u2019s disease. Endocr Rev. 2015;36(4):385\u2013486.","journal-title":"Endocr Rev"},{"issue":"2","key":"757_CR7","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1507\/endocrj.EJ12-0299","volume":"60","author":"K Kageyama","year":"2013","unstructured":"Kageyama K, Oki Y, Sakihara S, Nigawara T, Terui K, Suda T. Evaluation of the diagnostic criteria for Cushing\u2019s disease in Japan. Endocr J. 2013;60(2):127\u201335.","journal-title":"Endocr J"},{"issue":"5","key":"757_CR8","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1530\/EJE-13-0569","volume":"169","author":"G Ntali","year":"2013","unstructured":"Ntali G, Asimakopoulou A, Siamatras T, Komninos J, Vassiliadi D, Tzanela M, Tsagarakis S, Grossman AB, Wass JA, Karavitaki N. Mortality in Cushing\u2019s syndrome: systematic analysis of a large series with prolonged follow-up. Eur J Endocrinol. 2013;169(5):715\u201323.","journal-title":"Eur J Endocrinol"},{"issue":"12","key":"757_CR9","doi-asserted-by":"publisher","first-page":"4462","DOI":"10.1210\/jc.2014-3007","volume":"99","author":"M Debono","year":"2014","unstructured":"Debono M, Bradburn M, Bull M, Harrison B, Ross RJ, Newell-Price J. Cortisol as a marker for increased mortality in patients with incidental adrenocortical adenomas. J Clin Endocrinol Metab. 2014;99(12):4462\u201370.","journal-title":"J Clin Endocrinol Metab"},{"key":"757_CR10","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.12659\/AJCR.910521","volume":"19","author":"S Fujisato","year":"2018","unstructured":"Fujisato S, Urushibara T, Kasai H, Ishi D, Inafuku K, Fujinuma Y, Shinozaki T. A fatal case of atypical disseminated herpes zoster in a patient with meningoencephalitis and seizures associated with steroid immunosuppression. Am J Case Rep. 2018;19:1162\u20137.","journal-title":"Am J Case Rep"},{"key":"757_CR11","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1056\/NEJMcp1302674","volume":"369","author":"JI Cohen","year":"2013","unstructured":"Cohen JI. Herpes zoster. N Engl J Med. 2013;369:255\u201363.","journal-title":"N Engl J Med"},{"key":"757_CR12","doi-asserted-by":"publisher","first-page":"107983","DOI":"10.1016\/j.diabres.2019.107983","volume":"159","author":"M Saadatian-Elahi","year":"2020","unstructured":"Saadatian-Elahi M, Bauduceau B, Del-Signore C, Vanhems P. Diabetes as a risk factor for herpes zoster in adults: a synthetic literature review. Diabetes Res Clin Pract. 2020;159:107983.","journal-title":"Diabetes Res Clin Pract"},{"issue":"20","key":"757_CR13","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1056\/NEJM199505183322008","volume":"332","author":"GP Chrousos","year":"1995","unstructured":"Chrousos GP. 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