# Unprovoked Deep Vein Thrombosis as a Manifestation of Cushing's Disease

## TL;DR

A woman with unexplained deep vein thrombosis was later diagnosed with Cushing's disease, highlighting the condition as a potential risk factor for blood clots.

## Contribution

This case study highlights Cushing's disease as a possible cause of unprovoked venous thromboembolism, suggesting the need for screening in at-risk patients.

## Key findings

- The patient had two episodes of unprovoked DVT before being diagnosed with Cushing's disease.
- After successful treatment of Cushing's disease, the patient experienced significant weight loss and resolution of hypertension and insomnia.
- The case suggests that Cushing's disease should be considered in patients with unexplained venous thromboembolism.

## Abstract

Cushing's disease is a rare condition, and patients have a higher risk of thromboembolism, specifically venous events. We present a case of a middle-aged woman who underwent sleeve surgery many years ago and slowly regained weight. She had two episodes of unprovoked deep vein thrombosis (DVT), and no risk factors were identified at the time of these events. She presented 10 years later with easy bruising, myopathy, gradual weight gain, and insomnia, and was found to have ACTH-dependent pituitary Cushing’s. She successfully underwent endoscopic resection of her pituitary macroadenoma. She had worsening myalgia and myopathy immediately after surgery and is now recovering from glucocorticoid withdrawal syndrome after having untreated Cushing's disease for many years. Her insomnia has resolved almost completely, she has lost 60 pounds, her hypertension has resolved completely, and now she is off medications and remains in remission after 22 months. We conclude that Cushing’s disease should be viewed as a risk factor for unprovoked venous thromboembolism and screened for, especially in obese patients.