14,060 results match your criteria Cushing Syndrome


Quality of life impairment after a diagnosis of Cushing's syndrome.

Pituitary 2022 Jun 29. Epub 2022 Jun 29.

Endocrinology Dept, Germans Trias i Pujol Hospital & Research Institute, Universitat Internacional de Catalunya (UIC), CIBERER, Unit 747, ISCIII, 08916, Badalona, Spain.

This brief review is devoted mainly to publications in the last 5 years dealing with health-related quality of life (QoL) after a diagnosis of endogenous hypercortisolism, due to pituitary-dependent Cushing's disease (CD) or any other cause of Cushing syndrome (CS). Despite improvement after treatment, persistent physical morbidity, neurocognitive problems like worse executive capacity and memory as well as stress intolerance, depressive symptoms and more anxiety, lead to long-term impairment of QoL. Read More

View Article and Full-Text PDF

Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club.

Front Endocrinol (Lausanne) 2022 9;13:908727. Epub 2022 Jun 9.

Centre for Metabolic Bone Diseases, Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium.

Glucocorticoids are effective immunomodulatory drugs used for many inflammatory disorders as well as in transplant recipients. However, both iatrogenic and endogenous glucocorticoid excess are also associated with several side effects including an increased risk of osteoporosis and fractures. Glucocorticoid-induced osteoporosis (GIOP) is a common secondary cause of osteoporosis in adults. Read More

View Article and Full-Text PDF

Sex Differences in Hypercortisolism and Glucose-Metabolism Disturbances in Patients with Mild Autonomous Cortisol Secretion: Findings From a Single Center in China.

Front Endocrinol (Lausanne) 2022 9;13:857947. Epub 2022 Jun 9.

Department of Endocrinology, the First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.

Background And Objective: Mild autonomous cortisol secretion (MACS) presents with a marked female preponderance, but whether the sex difference in its distribution has any relevance to the presentation and outcome of the disease is unknown. The aim of this study was therefore to compare biochemical indices of hypercortisolism and impaired glucose metabolism between male and female patients with MACS.

Method: We enrolled a total of 98 patients with autonomous/possible autonomous cortisol secretion in our study, and indices of hypercortisolism and glucose metabolism were collected and compared between the male and female patients. Read More

View Article and Full-Text PDF

Posterior reversible encephalopathy syndrome in carcinoid tumor.

Proc (Bayl Univ Med Cent) 2022 19;35(4):537-539. Epub 2022 Apr 19.

Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas.

This case presents a patient with ectopic secretion of adrenocorticotrophic hormone from a carcinoid tumor resulting in severe hypertension, posterior reversible encephalopathy syndrome (PRES), and refractory status epilepticus. Secondary hypertension may be difficult to identify in critically ill patients. Severely uncontrolled hypertension presenting with PRES caused by Cushing syndrome is rare but should be considered. Read More

View Article and Full-Text PDF

Adrenalectomy improves blood pressure control in nonfunctioning adrenal incidentalomas and glycemic and lipid control in patients with autonomous cortisol secretion.

Endocrine 2022 Jun 25. Epub 2022 Jun 25.

Endocrinology & Nutrition Department, Ramón y Cajal University Hospital, Madrid, Spain.

Purpose: To compare the evolution of the cardiometabolic parameters in patients with nonfunctioning adrenal incidentalomas (NFAI) and autonomous cortisol secretion (ACS) who underwent adrenalectomy and those who were conservatively managed.

Methods: A retrospective study of all patients with NFAI and ACS submitted to surgery or in follow-up in our center between January 2011-October 2020. NFAI was defined as an adrenal incidentaloma with cortisol post-dexamethasone suppression test (DST) ≤ 50 nmol/L and ACS as values >50 nmol/L without specific clinical signs of overt Cushing´s syndrome. Read More

View Article and Full-Text PDF

Cushing's disease in children: unique features and update on genetics.

Pituitary 2022 Jun 24. Epub 2022 Jun 24.

Human Genetics & Precision Medicine, FORTH & ELPEN Research Institute, Heraklion & Athens, Greece.

In this brief report, we review the unique characteristics of Cushing disease (CD) in children, as well as the most important new genetic discoveries associated with childhood CD. We often forget it, but CD refers to Cushing syndrome caused by pituitary corticotroph adenomas only. Thus, here we only refer to the new discoveries associated with pituitary tumors. Read More

View Article and Full-Text PDF

Very Low-Calorie Ketogenic Diet: A Potential Application in the Treatment of Hypercortisolism Comorbidities.

Nutrients 2022 Jun 9;14(12). Epub 2022 Jun 9.

Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, 90127 Palermo, Italy.

A very low-calorie ketogenic diet (VLCKD) is characterized by low daily caloric intake (less than 800 kcal/day), low carbohydrate intake (<50 g/day) and normoproteic (1-1.5 g of protein/kg of ideal body weight) contents. It induces a significant weight loss and an improvement in lipid parameters, blood pressure, glycaemic indices and insulin sensitivity in patients with obesity and type 2 diabetes mellitus. Read More

View Article and Full-Text PDF

Genetic Basis of ACTH-Secreting Adenomas.

Int J Mol Sci 2022 Jun 19;23(12). Epub 2022 Jun 19.

Unit of Endocrinology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore-Fondazione Policlinico "Gemelli" IRCCS, Largo Gemelli 8, I-00168 Rome, Italy.

Cushing's disease represents 60-70% of all cases of Cushing's syndrome, presenting with a constellation of clinical features associated with sustained hypercortisolism. Molecular alterations in corticotrope cells lead to the formation of ACTH-secreting adenomas, with subsequent excessive production of endogenous glucocorticoids. In the last few years, many authors have contributed to analyzing the etiopathogenesis and pathophysiology of corticotrope adenomas, which still need to be fully clarified. Read More

View Article and Full-Text PDF

Hypothalamic-pituitary-adrenal axis recovery after treatment of Cushing's syndrome.

J Neuroendocrinol 2022 Jun 3. Epub 2022 Jun 3.

Department of Endocrinology, University Hospital Center Zagreb, Zagreb, Croatia.

After successful treatment for Cushing's syndrome (CS), secondary adrenal insufficiency develops as a result of the prior suppression of the hypothalamic-pituitary-adrenal (HPA) axis by excess cortisol in the body. Until the recovery of the HPA axis, glucocorticoid replacement therapy is required to enable normal functioning of the body and prevent adrenal crisis. Significant variation in the median time of recovery of the HPA axis is found in various cohorts of CS patients ranging from several weeks to years. Read More

View Article and Full-Text PDF

Recurrent Metatarsal Fractures in a Patient With Cushing Disease: A Case Report.

Cureus 2022 May 15;14(5):e25015. Epub 2022 May 15.

Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, USA.

Cushing syndrome (CS) can result from excess exposure to exogenous or endogenous glucocorticoids. The most common endogenous cause of CS is an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma, known as Cushing disease (CD). Patients typically present with characteristics including truncal obesity, moon facies, facial plethora, proximal muscle weakness, easy bruising, and striae. Read More

View Article and Full-Text PDF

Intermittent Blurry Vision: An Unexpected Presentation of Cushing's Syndrome Due to Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH).

Cureus 2022 May 15;14(5):e25017. Epub 2022 May 15.

Internal Medicine, Nazareth Hospital, Philadelphia, USA.

Cushing's syndrome (CS) is an uncommon endocrine disorder resulting from prolonged exposure to elevated glucocorticoids, with 10-15 million annual cases per the American Association of Neurological Surgeons. Exogenous and endogenous causes can further be divided into adrenocorticotropic hormone (ACTH) dependent (i.e Cushing's Disease) or ACTH independent. Read More

View Article and Full-Text PDF

An umbrella review on the use of antipsychotics in anxiety disorders: A registered report protocol.

PLoS One 2022 16;17(6):e0269772. Epub 2022 Jun 16.

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.

Anxiety disorders, including panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), agoraphobia, and specific phobia, are among the most common psychiatric disorders. Although the traditional pharmacologic treatments for anxiety included barbiturates and then benzodiazepines, the introduction of tricyclic antidepressants, followed by the selective serotonin reuptake inhibitors (SSRIs), marked a tidal shift in the treatment of anxiety. Although not approved for treatment of anxiety disorders (with the exception of trifluoperazine) there is ongoing off-label, unapproved use of both first-generation "typical" antipsychotics (FGAs) and second-generation or "atypical" antipsychotics (SGAs) for anxiety. Read More

View Article and Full-Text PDF

Case Report: Primary Aldosteronism and Subclinical Cushing Syndrome in a 49-Year-Old Woman With Hypertension Plus Hypokalaemia.

Front Cardiovasc Med 2022 30;9:911333. Epub 2022 May 30.

Department of Cardiology, Peking University First Hospital, Beijing, China.

Background: Coexisting primary aldosteronism (PA) and subclinical Cushing's syndrome (SCS) caused by bilateral adrenocortical adenomas have occasionally been reported. Precise diagnosis and treatment of the disease pose a challenge to clinicians due to its atypical clinical manifestations and laboratory findings.

Case Summary: A 49-year-old woman was admitted to our hospital due to fatigue, increased nocturia and refractory hypertension. Read More

View Article and Full-Text PDF

Differences in the spectrum of steroidogenic enzyme inhibition between Osilodrostat and Metyrapone in ACTH-Dependent Cushing Syndrome Patients.

Eur J Endocrinol 2022 Jun 1. Epub 2022 Jun 1.

J Bertherat, Service d'Endocrinologie et Maladies Métaboliques. Hôpitaux universitaires Paris-Centre, Assistance Publique - Hopitaux de Paris, Paris, France.

Introduction: Osilodrostat is a new 11 ß-hydroxylase inhibitor with a mode of action analogue to Metyrapone. The objective of this study was to compare steroidogenic profiles in patients treated by either Osilodrostat or Metyrapone for ACTH-dependent Cushing's Syndrome (CS).

Methods: Patients followed in Cochin hospital Endocrinology department between March 2019 and December 2021 for an ACTH-dependent CS, controlled by either Osilodrostat or Metyrapone were included. Read More

View Article and Full-Text PDF

A Pitfall of Falsely Elevated ACTH: A Case Report and Literature Review.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221103368

Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

A 35-year-old woman with unintentional weight gain, hyperpigmentation of bilateral palms, and general fatigue was initially suspected of Cushing's syndrome or adrenal insufficiency based on the isolated elevation of the plasma adrenocorticotropic hormone (ACTH) level (113.0 pg/mL) in the Siemens ACTH Immulite assay (ACTH [Immulite]). However, both of the diagnoses were excluded by screening tests including the overnight dexamethasone suppression test, the 24-hour urinary free cortisol excretion, and the ACTH stimulation test in spite of the consistent elevation of the plasma ACTH levels. Read More

View Article and Full-Text PDF

Fractures within 2 years of an obstetric hospitalization: analysis of nationwide administrative data in Japan.

J Bone Miner Metab 2022 Jun 12. Epub 2022 Jun 12.

Quality Management Center, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan.

Introduction: Pregnancy- and lactation-associated osteoporosis (PLO) is a condition in which young women develop fractures during pregnancy or breastfeeding. Though PLO is a severely debilitating disease, its pathophysiology and epidemiology have not been clarified and its treatment has not been established. We aimed to identify the incidence and factors associated with fractures occurring within 2 years following an obstetric hospitalization. Read More

View Article and Full-Text PDF

Successful resolution of ectopic Cushing syndrome by minimally invasive thoracoscopic resection of the neuroendocrine tumor of the thymus: a rare case report.

BMC Surg 2022 Jun 11;22(1):226. Epub 2022 Jun 11.

Department of Thoracic Surgery, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.

Background: Ectopic Cushing syndrome (ECS) is a sporadic condition. Even uncommon is an ECS that derives from a carcinoid tumor of the thymus. These tumors may pose several diagnostic and therapeutic conundrums. Read More

View Article and Full-Text PDF

The Mount Sinai Clinical Pathway for the Diagnosis and Management of Hypercortisolism due to Ectopic ACTH Syndrome.

J Endocr Soc 2022 Jul 6;6(7):bvac073. Epub 2022 May 6.

The Adrenal Center, Division of Endocrine, Diabetes and Bone Diseases, Department of Medicine at the Icahn School of Medicine at Mount Sinai, New York , NY, USA.

Neoplasms that secrete ectopic adrenocorticotropin (ACTH) may cause severe, life-threatening hypercortisolism. These tumors are often difficult to localize and treat, requiring a comprehensive and systematic management plan orchestrated by a multidisciplinary team. The Mount Sinai Adrenal Center hosted an interdisciplinary retreat of experts in adrenal disorders and neuroendocrine tumors (NETs) with the aim of developing a clinical pathway for the management of Cushing syndrome due to ectopic ACTH production. Read More

View Article and Full-Text PDF

Case Report: Adrenocortical Oncocytoma in a Patient with a Previous Contralateral Adrenalectomy for a Cortisol-Secreting Adenoma.

Front Surg 2022 19;9:897967. Epub 2022 May 19.

Endocrinology, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy.

Background: Oncocytomas are uncommon benign tumors that arise in various organs and are predominantly composed of oncocytes. Adrenocortical oncocytomas are extremely rare and are generally non-functioning.

Methods: We report the case of a 40-year-old patient with a progressively enlarging left adrenal mass. Read More

View Article and Full-Text PDF

Eyelid edema due to Cushing's syndrome.

Clin Case Rep 2022 Jun 2;10(6):e05940. Epub 2022 Jun 2.

Department of General Medicine Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan.

Cushing's syndrome (CS) shows diverse signs such as centripetal obesity, moon face, and buffalo hump, which can complicate the diagnosis. Facial features including eyelid edema, as an underrecognized sign, can be diagnostic clues for an excess of corticoids in a CS patient. Read More

View Article and Full-Text PDF

Effects of endocrine disorders on lipids and lipoproteins.

Authors:
Connie B Newman

Best Pract Res Clin Endocrinol Metab 2022 May 10:101667. Epub 2022 May 10.

Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, NY 10016, USA. Electronic address:

Endocrine diseases may be associated with dyslipidaemia and may increase atherosclerotic cardiovascular disease (ASCVD) risk. This chapter describes changes in lipids and lipoproteins in diseases of the pituitary, thyroid, adrenal glands, ovaries, and testes, the mechanisms for these changes, ASCVD risk in these endocrine disorders, and whether treatment of the endocrine disorder improves the lipid profile and reduces ASCVD risk. Acromegaly, GH deficiency, Cushing syndrome, chronic glucocorticoid replacement, hypothyroidism, PCOS and male hypogonadism can increase LDL-C and/or TG. Read More

View Article and Full-Text PDF

Shortening the duration of dual antiplatelet therapy after percutaneous coronary intervention for acute coronary syndrome: A systematic review and meta-analysis.

Am Heart J 2022 May 30;251:101-114. Epub 2022 May 30.

Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.

Introduction: The decision to shorten the duration of DAPT following PCI in patients with ACS remains controversial because of the concern for increased ischemic events.

Methods: We performed a comprehensive literature search in seven databases to explore the efficacy of 1 to 3 months of DAPT in patients who underwent PCI for ACS. Randomized controlled trials that compared 1 to 3 months with 6 to 12 months of DAPT after PCI for ACS were identified. Read More

View Article and Full-Text PDF

Primary pigmented nodular adrenal disease presenting as hypertensive crisis.

BMJ Case Rep 2022 Jun 1;15(6). Epub 2022 Jun 1.

Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India

We present a case of a young girl who presented with hypertensive crisis and recent onset weight gain with hirsutism. On evaluation for Cushing syndrome (CS), her cortisol concentration was high, showed a paradoxical cortisol rise on dexamethasone suppression and the adrenocorticotropic hormone (ACTH) was low. Adrenal imaging showed normal adrenal morphology. Read More

View Article and Full-Text PDF

Cushing's mortality in remission: not out of the woods.

J Clin Endocrinol Metab 2022 Jun 1. Epub 2022 Jun 1.

Dept of Oncology and Metabolism, The Medical School, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK.

View Article and Full-Text PDF

Laboratory Interventions to Eliminate Unnecessary Rapid COVID-19 Testing During a Reagent Shortage.

Am J Clin Pathol 2022 Jun 1. Epub 2022 Jun 1.

Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA.

Objectives: In the fall of 2020, US medical centers were running out of rapid coronavirus disease 2019 (COVID-19) tests. The aim of this study is to evaluate the impact of an intervention to eliminate rapid test misutilization and to quantify the effect of the countermeasures to control rapid test ordering using a test utilization dashboard.

Methods: Interventions were made to preserve a severely limited supply of rapid diagnostic tests based on real-time analysis of a COVID-19 test utilization dashboard. Read More

View Article and Full-Text PDF

A case of subcutaneous sarcoidosis in a patient with Cushing's syndrome.

An Bras Dermatol 2022 May 25. Epub 2022 May 25.

Department of Dermatology, Fukushima Medical University, Fukushima, Japan. Electronic address:

A 41-year-old female visited our department complaining of asymptomatic subcutaneous nodules on the right forearm. She had been diagnosed as having Cushing syndrome due to an adrenal tumor 5-months previously. After she underwent surgery for the adrenal tumor, the subcutaneous nodules gradually increased in number. Read More

View Article and Full-Text PDF

Factors predicting prolonged glucocorticoid therapy in patients with adrenal insufficiency after laparoscopic adrenalectomy.

Ann Med Surg (Lond) 2022 May 10;77:103390. Epub 2022 Mar 10.

University-Hospital of Parma, Department of Urology, Italy.

Introduction And Importance: Adrenal insufficiency (AI) is common after adrenalectomy for Primary Adrenal Cushing's syndrome (PACS), due to the inhibition of the Hypothalamic-Pituitary-Adrenal Axis (HPAA) by the functioning adrenal mass. The treatment of post-surgical AI is based mainly on glucocorticoid supplementation therapy. To date, however, there is no known predicting factor of the duration of supplementation therapy in patients treated with laparoscopic adrenalectomy for PACS. Read More

View Article and Full-Text PDF

Detecting patients with Cushing's syndrome: The importance of initial test selection.

Aust J Gen Pract 2022 06;51(6):453-454

BPharm, MBBS (Hons), MAACB, FRCPA, Consultant Pathologist, Department of Biochemistry, Western Diagnostic Pathology, WA; Medical School, The University of Western Australia, Perth, WA.

Background And Objectives: The recommended initial tests for suspected Cushing's syndrome are late-night salivary cortisol (LNSC), 24-hour urinary free cortisol (UFC) and the 1 mg overnight dexamethasone suppression test (ONDST). These tests have higher sensitivity and specificity than serum cortisol. The aim of this study was to determine the relative frequency of these requested tests in primary care. Read More

View Article and Full-Text PDF

Adrenal carcinoma: a case report.

J Med Case Rep 2022 May 30;16(1):229. Epub 2022 May 30.

National Hospital of Sri Lanka, Colombo 10, Sri Lanka.

Background: Adrenocortical carcinoma is a rare malignancy (0.5-2 cases/million/year) with a poor prognosis. Hypercortisolism, virilization, and compressive features are among the common presentations of adrenocortical carcinoma. Read More

View Article and Full-Text PDF

Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing's syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing's syndrome.

Langenbecks Arch Surg 2022 May 28. Epub 2022 May 28.

Department of General, Visceral, Transplant, Vascular and Pediatric Surgery at Würzburg University Hospital, Würzburg, Germany.

Purpose: In selected cases of severe Cushing's syndrome due to uncontrolled ACTH secretion, bilateral adrenalectomy appears unavoidable. Compared with unilateral adrenalectomy (for adrenal Cushing's syndrome), bilateral adrenalectomy has a perceived higher perioperative morbidity. The aim of the current study was to compare both interventions in endogenous Cushing's syndrome regarding postoperative outcomes. Read More

View Article and Full-Text PDF