Pituitary function before and after transsphenoidal adenomectomy in patients with Cushing's disease

1982 ◽  
Vol 65 (1-2) ◽  
pp. 29-40 ◽  
Author(s):  
B. Ambrosi ◽  
M. Giovanelli ◽  
S. M. Gaini ◽  
D. Bochicchio ◽  
E. Riva ◽  
...  
Keyword(s):  
Cushing’S Disease ◽  
Pituitary Function ◽  
Cushing's Disease ◽  
Before And After ◽  
Transsphenoidal Adenomectomy

scholarly journals Effect of one month ketoconazole treatment on GH, cortisol and ACTH release after ghrelin, GHRP-6 and GHRH administration in patients with cushing’s disease

2007 ◽  
Vol 51 (7) ◽  
pp. 1110-1117 ◽  
Author(s):  
Silvia R. Correa-Silva ◽  
Sérgio O. Nascif ◽  
Marcos R. Silva ◽  
Patrícia Molica ◽  
Ana-Maria J. Lengyel
Keyword(s):  
Cushing’S Disease ◽  
Pituitary Function ◽  
Cushing's Disease ◽  
Urinary Cortisol ◽  
Short Term ◽  
Gh Secretion ◽  
Before And After ◽  
Cortisol Responses ◽  
Cortisol Levels ◽  
Acth Release

GH responses to ghrelin, GHRP-6, and GHRH in Cushing’s disease (CD) are markedly blunted. There is no data about the effect of reduction of cortisol levels with steroidogenesis inhibitors, like ketoconazole, on GH secretion in CD. ACTH levels during ketoconazole treatment are controversial. The aims of this study were to compare the GH response to ghrelin, GHRP-6, and GHRH, and the ACTH and cortisol responses to ghrelin and GHRP-6 before and after one month of ketoconazole treatment in 6 untreated patients with CD. Before treatment peak GH (mg/L; mean ± SEM) after ghrelin, GHRP-6, and GHRH administration was 10.0 ± 4.5; 3.8 ± 1.6, and 0.6 ± 0.2, respectively. After one month of ketoconazole there was a significant decrease in urinary cortisol values (mean reduction: 75%), but GH responses did not change (7.0 ± 2.0; 3.1 ± 0.8; 0.9 ± 0.2, respectively). After treatment, there was a significant reduction in cortisol (mg/dL) responses to ghrelin (before: 30.6 ± 5.2; after: 24.2 ± 5.1). No significant changes in ACTH (pg/mL) responses before (ghrelin: 210.9 ± 69.9; GHRP-6: 199.8 ± 88.8) and after treatment (ghrelin: 159.7 ± 40.3; GHRP-6: 227 ± 127.2) were observed. In conclusion, after short-term ketoconazole treatment there are no changes in GH or ACTH responses, despite a major decrease of cortisol levels. A longer period of treatment might be necessary for the recovery of pituitary function.

RECURRENCE OF CUSHING'S DISEASE 10 YEARS AFTER TRANSSPHENOIDAL ADENOMECTOMY: REPORT OF A CASE

1996 ◽  
Vol 2 (3) ◽  
pp. 176-178
Author(s):  
Asumani S. Yeboah, MD ◽  
Joseph R. Tucci, MD, FACE
Keyword(s):  
Cushing’S Disease ◽  
Cushing's Disease ◽  
Transsphenoidal Adenomectomy

QUANTITATIVE ESTIMATION OF ADRENOCORTICAL HORMONES AND THEIR α-KETOLIC METABOLITES IN URINE

1963 ◽  
Vol 42 (1) ◽  
pp. 61-68 ◽  
Author(s):  
W. S. Cost ◽  
J. Pol ◽  
A. Korten
Keyword(s):  
Cushing’S Disease ◽  
Late Effects ◽  
Quantitative Estimation ◽  
Addison’S Disease ◽  
Cushing's Disease ◽  
Addison's Disease ◽  
Adrenogenital Syndrome ◽  
Adrenocortical Hormones ◽  
Before And After

ABSTRACT Urinary corticosteroid patterns were estimated before and after adrenocortical stimulation by exogenous corticotrophin (ACTH). The results indicate that changes in corticosteroid biosynthesis and metabolism depend on the duration of stimulation. Immediate effects are an increase in corticosterone production above that of cortisol (low F/B-ratio) and a shift in the metabolism of both cortisol and corticosterone in favour of all 11-hydroxycompounds. Late effects are characteristic of the patterns in Cushing's disease including a high F/B-ratio and low values for the 11-hydroxy-allocompounds (allotetrahydrocortisol and allotetrahydrocorticosterone). Changes in the ratios between cortisol, corticosterone and Reichstein's S as observed in Cushing's disease, adrenogenital syndrome and Addison's disease can be imitated by ACTH-induced acceleration of corticosteroid biosynthesis.

scholarly journals Transsphenoidal Surgery for Cushing's Disease

1986 ◽  
Vol 79 (5) ◽  
pp. 262-269 ◽  
Author(s):  
R Fahlbusch ◽  
M Buchfelder ◽  
O A Müller
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing’S Disease ◽  
Transsphenoidal Surgery ◽  
Dynamic Testing ◽  
Remission Rate ◽  
Cushing's Syndrome ◽  
Bilateral Adrenalectomy ◽  
Pituitary Function ◽  
Cushing's Disease ◽  
Mortality And Morbidity

A series of 101 patients with Cushing's disease underwent transsphenoidal surgery. Diagnosis was fundamentally based on dynamic testing, mainly on the dosage-dependent suppression of cortisol after dexamethasone. The effect of surgery was monitored by intraoperative ACTH measurements. In 96 out of 101 patients a microadenoma of the pituitary was identified and removed selectively. In 74% of patients there was a clinical and endocrinological remission of Cushing's disease. Four ‘operative failures’ after selective adenomectomy underwent hypophysectomy in a second operation and each remitted. Thus the overall remission rate was 77%. In general, bilateral adrenalectomy was performed in patients who had failed to remit after selective adenomectomy. Although there is a considerable mortality and morbidity in patients with Cushing's syndrome, complications attributed to surgery were low. Two patients died postoperatively. In general, an improvement of disturbed pituitary function was noted after selective adenomectomy.

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