Ectopic ACTH Syndrome Presenting as Refractory Renal Potassium Wasting in Metastatic Uterine Neuroendocrine Carcinoma (KIDNEY WEEK 2026) - Oct 2, 2026 - Abstract #SA-PO0619; Pres time: Oct 24, 2026; 10:00 AM - 12:00 PM; Location: Exhibit Hall A, Convention Center; "AM cortisol was 77.1 mcg/dL, ACTH 81.7 pg/mL; cortisol was unsuppressed after high-dose dexamethasone...Spironolactone, amiloride, potassium, and ketoconazole improved K and BP (Figure). She transitioned to osilodrostat; voriconazole was added for aspergillosis...Discussion This case illustrates EAS as a nephrology diagnosis with cortisol-driven apparent mineralocorticoid excess causing hypertension, alkalosis, and kaliuresis despite suppressed aldosterone. The rapid shift from refractory hypokalemia to life-threatening hyperkalemia highlights bidirectional electrolyte risks when steroidogenesis inhibitors are compounded by CYP3A4-inhibiting azoles, requiring close monitoring and early de-escalation."
Metastases • Cardiovascular • Endocrine Cancer • Endocrine Disorders • Heart Failure • Hypertension • Metabolic Disorders • Nephrology • Neuroendocrine Carcinoma • Oncology • Renal Disease • Respiratory Diseases • Solid Tumor • Uterine Cancer
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Ashraf S. Rjob; Eshetu L. Obole
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