scholarly journals Phase-shifted Diurnal Rhythm of Cortisol Secretion in a Patient with Cushing's Syndrome due to Adrenocortical Adenoma.

1988 ◽  
Vol 35 (2) ◽  
pp. 261-266
Author(s):  
AKIRA SHIMATSU ◽  
YUZURU KATO ◽  
HIDETA SAKAMI ◽  
YOSHIKATSU NAKAI ◽  
HIROO IMURA
Keyword(s):  
Cushing’S Syndrome ◽  
Diurnal Rhythm ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Cortisol Secretion

DIURNAL VARIATION IN PLASMA CORTISOL AND PROLACTIN IN PATIENTS WITH CUSHING'S SYNDROME

1978 ◽  
Vol 88 (4) ◽  
pp. 737-743 ◽  
Author(s):  
Claus Hagen ◽  
Henrik Kehlet ◽  
Christian Binder
Keyword(s):  
Cushing’S Syndrome ◽  
Diurnal Rhythm ◽  
Plasma Cortisol ◽  
Normal Subjects ◽  
Cushing's Syndrome ◽  
Ectopic Acth Syndrome ◽  
Adrenocortical Adenoma ◽  
Plasma Prolactin ◽  
Ectopic Acth ◽  
Oat Cell Carcinoma

ABSTRACT To evaluate the relationship between plasma prolactin and cortisol in patients with Cushing's syndrome, the 24 h pattern of these hormones was measured in normal subjects and in 5 patients with pituitary dependent Cushing's syndrome and 2 patients with Cushing's syndrome due to an adrenocortical adenoma and ectopic secretion of ACTH. The normal subjects showed an increase in plasma prolactin during late sleep without correlation (P > 0.05) to changes in plasma cortisol. All patients had normal basal levels (between 10 a. m. and 12 p. m.) of plasma prolactin. Four of 5 patients with pituitary dependent Cushing's syndrome had an absent diurnal rhythm of plasma prolactin. One patient classified as pituitary dependent Cushing's syndrome on the basis of adrenal pathology, but pituitary independent on the basis of the dexamethasone suppression test had a normal circadian rhythm of plasma prolactin suggesting that the disease is not pituitary dependent at this stage. Two patients with pituitary independent Cushing's syndrome, one with adrenocortical adenoma and one with an oat cell carcinoma of the lung and the ectopic ACTH syndrome and very elevated plasma cortisol levels showed a normal and an absent diurnal rhythm of prolactin, respectively.

High [18F] 2-fluoro-2-deoxy-d-glucose (FDG) uptake of adrenocortical adenoma showing subclinical Cushing's syndrome

2003 ◽  
Vol 17 (5) ◽  
pp. 403-406 ◽  
Author(s):  
Akiko Shimizu ◽  
Noboru Oriuchi ◽  
Yoshito Tsushima ◽  
Tetsuya Higuchi ◽  
Jun Aoki ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Subclinical Cushing’S Syndrome ◽  
Fdg Uptake

scholarly journals Reversible alterations in cardiac morphology and functions in a patient with Cushing's syndrome

2014 ◽  
Vol 2014 ◽  
Author(s):  
Hiroaki Iwasaki
Keyword(s):  
Cushing’S Syndrome ◽  
Interventricular Septum ◽  
Urinary Free Cortisol ◽  
Cushing's Syndrome ◽  
Left Ventricular ◽  
Multidetector Row Computed Tomography ◽  
List Type ◽  
Adrenocortical Adenoma ◽  
Cardiac Morphology ◽  
Free Cortisol

Summary A 45-year-old female was referred for endocrine evaluation of an incidental mass (31×24 mm in diameter) on the right adrenal gland. The patient was normotensive and nondiabetic, and had no history of generalised obesity (body weight, 46 kg at 20 years of age and 51.2 kg on admission); however, her waist-to-hip ratio was 0.97. Elevated urinary free cortisol levels (112–118 μg/day) and other findings indicated adrenocorticotrophic hormone-independent Cushing's syndrome due to right adrenocortical adenoma. Echocardiography before adrenalectomy revealed concentric left ventricular (LV) hypertrophy with a particular increase in interventricular septum thickness leading to impaired systolic and diastolic functions. Upon surgical remission of hypercortisolism, the asymmetric hypertrophy disappeared and the cardiac dysfunctions were considerably ameliorated. Although the mechanism(s) by which excessive cortisol contributes to LV wall thickness remain(s) unclear, serial echocardiography and cardiac multidetector-row computed tomography may support the notion that abnormal fat deposition in the myocardium owing to hypercortisolism appears to be an important factor for the reversible change in the cardiac morphology. Learning points Patients with Cushing's syndrome occasionally exhibit severe LV hypertrophy related to systolic and diastolic dysfunctions although they have neither hypertension nor diabetes mellitus. Biological remission of hypercortisolism can normalise structural and functional cardiac parameters and help in differentiating the cardiac alterations induced by excessive cortisol from those induced by other diseases. Excessive lipid accumulation within the heart before myocardial fibrosis may be implicated in reversible alterations in the cardiac morphology by Cushing's syndrome. Early diagnosis and treatment of Cushing's syndrome appear to be pivotal in preventing irreversible cardiac dysfunctions subsequent to cardiovascular events and heart failure.

Cyclic Cushing's syndrome combined with cortisol suppressible, dexamethasone non-suppressible ACTH secretion: a new variant of Cushing's syndrome

1985 ◽  
Vol 110 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Hans-Udo Schweikert ◽  
Horst Lorenz Fehm ◽  
Rudolf Fahlbusch ◽  
Rainer Martin ◽  
Rainer Kolloch ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Normal Tissue ◽  
Plasma Cortisol ◽  
Cushing's Syndrome ◽  
Cortisol Secretion ◽  
Plasma Acth ◽  
Acth Secretion ◽  
Normal Response ◽  
New Variant ◽  
Marked Suppression

Abstract. A 55 year old woman with an unusual form of Cushing's disease was studied. During several periods (periods lasting up to 84 days) evidence of cortisol hypersecretion with cycles occurring every 6 days was found. Suppression of plasma cortisol through orally administered dexamethasone (up to 32 mg per day) could not be achieved either during periods of cyclic cortisol hypersecretion or during apparent remission with normal cortisol secretion. Marked suppression of plasma ACTH was measured in response to an iv infusion of 50 mg cortisol over a period of 55 min whereas a similar test with 2 mg dexamethasone (iv bolus) did not suppress ACTH secretion. Transsphenoidal exploration of the sella revealed a tumour surrounding the anterior pituitary. Examination of the pituitary showed a few tiny tumour structures embedded in normal tissue which could not be removed, when the tumour was resected selectively under preservation of normal appearing tissue. Post-operatively, clinical and chemical remission (normal response to 1 mg dexamethasone) was observed for about 4 months. Thereafter, cortisol hypersecretion occurred again necessitating bilateral adrenalectomy. Our results are compatible with the assumption that normal hypothalamic-pituitary-adrenal suppressibility with cortisol, but not with dexamethasone, was caused by the loss of feedback receptors for dexamethasone in the presence of cortisol receptors in the cells which secrete ACTH or CRF. The combination of cyclic hypercortisolism with dexamethasone non-suppressible Cushing's syndrome has not been reported before and thus represents a new variant of Cushing's syndrome.

Values for Urinary Free Cortisol during Treatment with Amino-Glutethimide for Cushing’s Syndrome

1973 ◽  
Vol 19 (9) ◽  
pp. 1067-1068 ◽  
Author(s):  
Karl W Schmitt ◽  
Roger Juselius ◽  
James Hanlon ◽  
David Steed
Keyword(s):  
Cushing’S Syndrome ◽  
Urinary Free Cortisol ◽  
Cushing's Syndrome ◽  
Sensitive Indicator ◽  
Cortisol Secretion ◽  
Clinical Correlation ◽  
Free Cortisol ◽  
Amino Glutethimide

Abstract Of the chemical tests used, we found that values for urinary free cortisol had the best clinical correlation and were the most sensitive indicator of cortisol secretion in a patient with Cushing’s syndrome who was treated with amino-glutethimide.

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