دورية أكاديمية
Preclinical Cushing's syndrome in patients with an adrenal incidentaloma.
| العنوان: | Preclinical Cushing's syndrome in patients with an adrenal incidentaloma. |
|---|---|
| المؤلفون: | Tjan-Heijnen VC; Department of Endocrinology, University Hospital Nijmegen, Netherlands., Hermus AR, Kemink SA, Mudde AH, Pieters GF, Smals AG, Kloppenborg PW |
| المصدر: | The Netherlands journal of medicine [Neth J Med] 1998 Mar; Vol. 52 (3), pp. 111-5. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Van Zuiden Communications Country of Publication: Netherlands NLM ID: 0356133 Publication Model: Print Cited Medium: Print ISSN: 0300-2977 (Print) Linking ISSN: 03002977 NLM ISO Abbreviation: Neth J Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2002- : Alphen aan de Rijn, The Netherlands : Van Zuiden Communications Original Publication: Haarlem, Bohn |
| مواضيع طبية MeSH: | Adrenal Gland Neoplasms/*complications , Cushing Syndrome/*etiology, Adrenal Gland Neoplasms/surgery ; Adrenocorticotropic Hormone/blood ; Aged ; Cushing Syndrome/diagnosis ; Dexamethasone ; Female ; Humans ; Hydrocortisone/blood ; Male ; Middle Aged ; Radioimmunoassay |
| مستخلص: | Background: Autonomous (hyper-)secretion of cortisol without classical stigmata of Cushing's syndrome occurs in 10-15% of patients with incidentally detected adrenal tumors (incidentalomas). Methods: We present the clinical and biochemical data of four such patients. Two patients had hypertension and one both hypertension and non-insulin-dependent diabetes mellitus, but none showed classical stigmata of Cushing's syndrome. Results: All patients showed insufficient suppression of plasma cortisol during a 1 mg dexamethasone screening test. Plasma ACTH levels were suppressed in all patients. However, in three out of four patients the diurnal rhythm of plasma cortisol was intact and these three patients also showed a response of plasma cortisol after administration of corticotropin-releasing hormone. All patients underwent unilateral adrenalectomy. A carcinoma was found in one patient and an adenoma in the remaining three. Postoperatively, blood pressure had normalized in 2 out of 3 hypertensive patients, whereas non-insulin-dependent diabetes mellitus had disappeared in 1 patient. Postoperative endocrine evaluation showed no abnormalities anymore. Conclusions: We conclude that dexamethasone testing may reveal autonomous (hyper-)secretion of cortisol in adrenal incidentalomas. Adrenalectomy should be considered, especially when hypertension and/or non-insulin-dependent diabetes mellitus are present. One should be alert to the development of adrenal insufficiency after unilateral adrenalectomy. |
| المشرفين على المادة: | 7S5I7G3JQL (Dexamethasone) 9002-60-2 (Adrenocorticotropic Hormone) WI4X0X7BPJ (Hydrocortisone) |
| تواريخ الأحداث: | Date Created: 19980526 Date Completed: 19980709 Latest Revision: 20191102 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/s0300-2977(97)00091-0 |
| PMID: | 9599968 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder كن أول من يترك تعليقا!