scholarly journals Exaggerated Response of Adrenocorticotropic Hormone to Growth Hormone-Releasing Peptide-2 Test in Cushing's Disease

2009 ◽  
Vol 49 (8) ◽  
pp. 365-369 ◽  
Author(s):  
Satoru SAKIHARA ◽  
Kazunori KAGEYAMA ◽  
Atsufumi MATSUMOTO ◽  
Hidetoshi IKEDA ◽  
Yuko TSUSHIMA ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Cushing's Disease

scholarly journals Cushing’s Disease in a 7-Month-Old Girl due to a Tumor Producing Adrenocorticotropic Hormone and Thyreotropin-Secreting Hormone

1999 ◽  
Vol 31 (1) ◽  
pp. 7-11 ◽  
Author(s):  
J.V. List ◽  
S. Sobottka ◽  
A. Huebner ◽  
C. Bonk ◽  
J. Koy ◽  
...  
Keyword(s):  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Cushing's Disease

Cushing's Disease in Childhood: Benign Intracranial Hypertension after Trans-sphenoidal Adenomectomy

Neurosurgery ◽  
1983 ◽  
Vol 13 (2) ◽  
pp. 195-198 ◽  
Author(s):  
Mark N. Weissman ◽  
Larry K. Page ◽  
Raphael L. Bejar
Keyword(s):  
Intracranial Hypertension ◽  
Steroid Therapy ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Benign Intracranial Hypertension ◽  
Pituitary Microadenoma

Abstract A 7-year-old girl presented with the physical and endocrinological stigmata of Cushing's disease. An adrenocorticotropic hormone (ACTH)-producing pituitary microadenoma was excised. Three weeks after trans-sphenoidal adenomectomy, the patient developed benign intracranial hypertension. Although ACTH levels had decreased to normal, the serum cortisol had fallen to subnormal levels. The child responded to exogenous steroid therapy, which was gradually tapered and discontinued after 5 months. Normal pituitary and adrenal functions persist 2 years later.

scholarly journals Cyclic Cushing's disease with misleading inferior petrosal sinus sampling results during a trough phase

2015 ◽  
Vol 38 (2) ◽  
pp. E7 ◽  
Author(s):  
Vivien Bonert ◽  
Namrata Bose ◽  
John D. Carmichael
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Diagnostic Testing ◽  
Cushing's Syndrome ◽  
Cushing's Disease ◽  
Inferior Petrosal Sinus ◽  
Inferior Petrosal Sinus Sampling ◽  
Acth Secreting ◽  
Transsphenoidal Resection

Diagnosing Cushing's syndrome is challenging and is further hampered when investigations are performed in a patient with cyclic Cushing's syndrome. A subset of patients with Cushing's syndrome exhibit periods of abnormal cortisol secretion with interspersed normal secretion. Patients can have periods of clinical improvement during these quiescent phases or remain symptomatic. Initial diagnostic testing can be challenging because of the unpredictable durations of the peak and trough phases, and it is especially challenging when the diagnosis of cyclic Cushing's syndrome has not yet been determined. Here, the authors present the case of a patient with Cushing's disease with a pathology-proven adrenocorticotropic hormone (ACTH)–secreting pituitary adenoma and whose initial inferior petrosal sinus sampling (IPSS) results were deemed indeterminate; further studies elucidated the diagnosis of cyclic Cushing's syndrome. Repeat IPSS was diagnostic of a central source for ACTH secretion, and the patient was treated successfully with transsphenoidal resection. Literature concerning the diagnosis and management of cyclic Cushing's syndrome is also reviewed.

Cushing's disease: results of transsphenoidal microsurgery with emphasis on surgical failures

1990 ◽  
Vol 72 (3) ◽  
pp. 363-369 ◽  
Author(s):  
George T. Tindall ◽  
Carl J. Herring ◽  
Richard V. Clark ◽  
David A. Adams ◽  
Nelson B. Watts
Keyword(s):  
Cushing’S Disease ◽  
Preoperative Diagnosis ◽  
Adrenocorticotropic Hormone ◽  
Remission Rate ◽  
Cushing's Disease ◽  
Sustained Remission ◽  
Original Diagnosis ◽  
Content Type ◽  
Transsphenoidal Microsurgery

✓ From 1977 to 1988, 56 patients with a preoperative diagnosis of Cushingαs disease were treated by transsphenoidal microsurgical exploration of the pituitary gland. In 42 patients, a discrete tumor was found and a selective adenomectomy was performed. Total hypophysectomy was performed in nine patients. In an attempt to preserve pituitary function, a technique of subtotal hypophysectomy was utilized in the remaining five patients. Regular and adequate follow-up results were obtained in 53 patients. A sustained remission was obtained in 45 of these 53 patients for a remission rate of 84.9%. Eight patients were classified as therapeutic failures. The causes for failure included: 1) invasive tumor; 2) hyperplasia mistaken for an adenoma; 3) a presumed ectopic source of adrenocorticotropic hormone; 4) misdiagnosis; 5) atypical tumor; and 6) recurrence of disease after remission. In cases of therapeutic failure, the original diagnosis of Cushing's disease must be reevaluated and treatment continued until sustained remission is achieved. Necessary measures to help avoid surgical failures and an approach for further diagnostic and therapeutic maneuvers in these cases are discussed.

Successful treatment of childhood-onset Cushing's disease is associated with persistent reduction in growth hormone secretion

2004 ◽  
Vol 60 (2) ◽  
pp. 169-174 ◽  
Author(s):  
P. V. Carroll ◽  
J. P. Monson ◽  
A. B. Grossman ◽  
G. M. Besser ◽  
P. N. Plowman ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Successful Treatment ◽  
Cushing’S Disease ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Cushing's Disease ◽  
Childhood Onset

Growth hormone (GH) status following cure of cushing's disease

1998 ◽  
Vol 8 (4) ◽  
pp. 317
Author(s):  
NR Hughes ◽  
CA Lissett ◽  
SM Shalet
Keyword(s):  
Growth Hormone ◽  
Cushing’S Disease ◽  
Cushing's Disease

scholarly journals Update on the management of recurrent Cushing's disease

2015 ◽  
Vol 38 (2) ◽  
pp. E16 ◽  
Author(s):  
Martin J. Rutkowski ◽  
Patrick M. Flanigan ◽  
Manish K. Aghi
Keyword(s):  
Patient Outcomes ◽  
Cushing’S Disease ◽  
Adrenocorticotropic Hormone ◽  
Bilateral Adrenalectomy ◽  
Cushing's Disease ◽  
Tumor Control ◽  
Repeat Resection ◽  
Risks And Benefits ◽  
Acth Secreting

After transsphenoidal surgery, Cushing's disease (CD) shows excellent long-term remission rates, but it may recur and pose a therapeutic challenge. Findings in recent published reports on the treatment of recurrent adrenocorticotropic hormone (ACTH)–secreting tumors suggest that repeat resection, radiation-based therapies such as Gamma Knife surgery and proton-beam radiosurgery, pharmacotherapy, and bilateral adrenalectomy all have important roles in the treatment of recurrent CD. Each of these interventions has inherent risks and benefits that should be presented to the patient during counseling on retreatment options. Radiation-based therapies increasingly appear to have efficacies similar to those of repeat resection in achieving biochemical remission and tumor control. In addition, an expanding retinue of medication-based therapies, several of which are currently being evaluated in clinical trials, has shown some promise as tertiary adjunctive therapies. Lastly, bilateral adrenalectomy may offer durable control of refractory recurrent CD. An increasing number of published studies with long-term patient outcomes highlight the evolving treatment patterns in the management of recurrent CD.

scholarly journals Metabolic, Cardiovascular, and Cerebrovascular Outcomes in Growth Hormone-Deficient Subjects with Previous Cushing’s Disease or Non-Functioning Pituitary Adenoma

2010 ◽  
Vol 95 (2) ◽  
pp. 630-638 ◽  
Author(s):  
Susan M. Webb ◽  
Daojun Mo ◽  
Steven W. J. Lamberts ◽  
Shlomo Melmed ◽  
Francesco Cavagnini ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Cushing's Disease
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