Also known as: Heart attack
A 10-year-old morbidly obese girl presents to the ER after collapsing during gym class with a heart attack. This is the inciting event that drives the diagnostic mystery, as heart attacks are extremely rare in children and lead the team to search for an underlying cause.
The ultimate diagnosis: Jessica has a pituitary tumor causing Cushing's disease with cyclical hypercortisolism, which explains all her symptoms including obesity, hypertension, blood clots, heart attack, skin necrosis, and stunted growth. The tumor is surgically removed via transsphenoidal approach.
Also known as: Dying skin tissue
Jessica develops severe, painful skin necrosis primarily affecting her breast tissue during treatment. Initially suspected to be warfarin-induced, it is ultimately revealed to be caused by hypercalcemia from Cushing's disease. This complication creates urgent time pressure and nearly requires emergency mastectomy.
Also known as: Temporary psychosis
During the hyperinsulinemic euglycemic clamp procedure, Jessica becomes violent and psychotic with uncontrollable rage. Initially thought to be hypoglycemia from the test, but blood work shows normal glucose, making it another symptom requiring explanation.
A clinic patient has a massive 30-pound benign ovarian tumor. She initially refuses surgery because she believes it's cosmetic and fears her husband will find her less attractive. House convinces her husband to persuade her to have the surgery.