Vnitr Lek 2018, 64(4):450-456 | DOI: 10.36290/vnl.2018.064
Cyclic Cushing's syndrome: a case study and overview
- 1 V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava, Slovenská republika
- 2 Klinika onkologickej chirurgie LF UK a Onkologický ústav sv. Alžbety, Bratislava, Slovenská republika
- 3 Neurochirurgická klinika LF UK a UNB, Nemocnica Akademika L. Dérera, Bratislava, Slovenská republika
- 4 Pracovisko BIONT, a.s., Bratislava, Slovenská republika
Cushing's syndrome and especially Cushing's disease represent diagnostically and therapeutically complicated medical situations. In some patients, cyclic changes in cortisol production additionally hamper the diagnosis in terms of source identification and management of hormone overproduction. It may not be clear, whether the patient is cured or not even years after the treatment. It is a rare disorder variant, but we assume that it is underdiagnosed and it's incidence is actually higher. The article deals with a complicated course of diagnosis and treatment in a patient with cyclic Cushing's syndrome.
Keywords: Cushing's disease; cyclic Cushing's syndrome; hypercortisolism
Received: March 23, 2017; Accepted: January 22, 2018; Published: April 1, 2018 Show citation
References
- Boscaro M, Barzon L, Fallo F et al. Cushing's syndrome. Lancet 2001; 357(9258): 783-791. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140-6736(00)04172-6>.
Go to original source...
Go to PubMed...
- Meinardi JR, Wolffenbuttel BHR, Dullaart RP. Cyclic Cushing's syndrome: a clinical challenge. Eur J Endocrinol 2007; 157(3): 245-254. Dostupné z DOI: <http://dx.doi.org/10.1530/EJE-07-0262>.
Go to original source...
Go to PubMed...
- Alexandraki KI, Kaltsas GA, Isidori AM et al. The prevalence and characteristic features of cyclicity and variability in Cushing's disease. Eur J Endocrinol 2009; 160(6): 1011-1018. Dostupné z DOI: <http://dx.doi.org/10.1530/EJE-09-0046>.
Go to original source...
Go to PubMed...
- Kršek M, Čáp J, Hána V et al. Doporučení České endokrinologické společnosti pro léčbu Cushingova syndromu v dospělosti. Vnitř Lék 2013; 59(9): 819-827.
Go to PubMed...
- Brown RD, Van Loon GR, Orth DN et al. Cushing's disease with periodic hormonogenesis: one explanation for paradoxical response to dexamethasone. J Clin Endocrinol Metab 1973; 36(3): 445-451. Dostupné z DOI: <http://dx.doi.org/10.1210/jcem-36-3-445>.
Go to original source...
Go to PubMed...
- Bailey RE. Periodic hormonogenesis - a new phenomenon. Periodicity in function of a hormone-producing tumor in man. J Clin Endocrinol Metab 1971; 32(3): 317-327. Dostupné z DOI: <http://dx.doi.org/10.1210/jcem-32-3-317>.
Go to original source...
Go to PubMed...
- Bassoe HH, Emberland R, Stoa KF. Fluctuating steroid excretion in Cushing's syndrome. Acta Endocrinol (Copenh) 1958; 28(2): 163-168.
Go to original source...
Go to PubMed...
- Orth DN. Cushing's syndrome. N Engl J Med 1995; 332(12): 791-803. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199503233321207>. Erratum in N Engl J Med 1995; 332(22): 1527.
Go to original source...
Go to PubMed...
- Petersenn S, Newell-Price J, Findling JW et al. High variability in baseline urinary free cortisol values in patients with Cushing's disease. Clin Endocrinol (Oxf) 2014; 80(2): 261-269. Dostupné z DOI: <http://dx.doi.org/10.1111/cen.12259>.
Go to original source...
Go to PubMed...
- Atkinson B, Mullan KR. What is the best approach to suspected cyclical Cushing syndrome? Strategies for managing Cushing's syndrome with variable laboratory data. Clin Endocrinol (Oxf) 2011; 75(1): 27-30. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365-2265.2011.04033.x>.
Go to original source...
Go to PubMed...