Intermittent hypercortisolism: a disorder strikingly prevalent after hypophysial surgical procedures.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
D H StreetenA D Joachimpillai

Abstract

To determine the frequency of intermittent hypercortisolism in a consecutive series of patients with Cushing's disease who underwent hypophysial surgical treatment. Thirty-three patients with hypercortisolism of central origin underwent follow-up at approximately annual intervals for prolonged periods after a transsphenoidal pituitary surgical procedure. Clinical evaluation was done, and urinary steroid measurements, as well as dexamethasone suppression tests in some patients, were performed. Frequently normal but intermittently increased urinary 17-hydroxycorticosteroid or cortisol excretion (or both) was found in six patients postoperatively, associated with intermittently severe hypertension, headaches, and weakness in only one patient. In a seventh patient, intermittently excessive cortisol excretion was clearly evident preoperatively. Because corticoid excretion was variable preoperatively in three of the seven study patients, we conclude that intermittent hypercortisolism is commoner than previous evidence has shown, constitutes an extremely difficult diagnostic problem, and did not result from but failed to be cured by pituitary surgical treatment in 6 of 33 patients (18%). The findings emphasize the need for regular fol...Continue Reading

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Citations

Jun 13, 2015·BMC Endocrine Disorders·E NoctorA Agha
Mar 18, 2009·European Journal of Endocrinology·Krystallenia I AlexandrakiAshley B Grossman
Jul 14, 2001·Current Opinion in Obstetrics & Gynecology·C E Miller
Oct 24, 2019·BMC Endocrine Disorders·Adriana AlbaniMartin Reincke
May 11, 2021·Frontiers in Endocrinology·Renata Świątkowska-StodulskaKrzysztof Sworczak

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