Treatment Options in Cushing's Disease.

Clinical Medicine Insights. Oncology
Ahmed RizkTsambika Psaras

Abstract

Endogenous Cushing's syndrome is a grave disease that requires a multidisciplinary and individualized treatment approach for each patient. Approximately 80% of all patients harbour a corticotroph pituitary adenoma (Cushing's disease) with excessive secretion of adrenocorticotropin-hormone (ACTH) and, consecutively, cortisol. The goals of treatment include normalization of hormone excess, long-term disease control and the reversal of comorbidities caused by the underlying pathology. The treatment of choice is neurosurgical tumour removal of the pituitary adenoma. Second-line treatments include medical therapy, bilateral adrenalectomy and radiation therapy. Drug treatment modalities target at the hypothalamic/pituitary level, the adrenal gland and at the glucocorticoid receptor level and are commonly used in patients in whom surgery has failed. Bilateral adrenalectomy is the second-line treatment for persistent hypercortisolism that offers immediate control of hypercortisolism. However, this treatment option requires a careful individualized evaluation, since it has the disadvantage of permanent hypoadrenalism which requires lifelong glucocorticoid and mineralocorticoid replacement therapy and bears the risk of developing Nelson'...Continue Reading

References

Jul 1, 1978·Annals of Internal Medicine·D N Orth
Mar 1, 1979·The New England Journal of Medicine·J P LutonH Bricaire
Oct 1, 1991·Clinical Endocrinology·N SoninoD Ziliotto
Oct 1, 1990·Clinical Endocrinology·M D LittleyM L Sutton
Oct 1, 1987·Clinical Endocrinology·B G RobinsonJ N Stiel
Sep 15, 1988·Annals of Internal Medicine·T J MampalamC B Wilson
Mar 7, 1986·JAMA : the Journal of the American Medical Association·G DicksteinD Barzilai
Sep 24, 1987·The New England Journal of Medicine·N Sonino
May 1, 1980·Annals of Internal Medicine·D E SchteingartB A Therrien
Sep 1, 1981·Pharmacotherapy·R J Santen, R I Misbin
Jun 1, 1994·The Journal of Steroid Biochemistry and Molecular Biology·D Engelhardt, M M Weber
Apr 1, 1994·Clinical Endocrinology·J Etxabe, J A Vazquez
Jan 1, 1994·Journal of Neurosurgery·Z RamE H Oldfield
Oct 1, 1996·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·R W TsangW J Simpson
Apr 20, 1999·Endocrinology and Metabolism Clinics of North America·N Sonino, M Boscaro
Jun 12, 1999·Annals of Internal Medicine·B SwearingenN T Zervas
Oct 17, 2002·Annals of the New York Academy of Sciences·Damian Morris, Ashley Grossman
Dec 21, 2002·Minimally Invasive Neurosurgery : MIN·P CappabiancaE de Divitiis
Apr 5, 2003·Pituitary·Lynnette K Nieman
Nov 1, 1952·The American Journal of Medicine·C M PLOTZC RAGAN
Nov 13, 2003·Postgraduate Medical Journal·P DeJ S Davies
Dec 13, 2003·The Journal of Clinical Endocrinology and Metabolism·G ArnaldiM Boscaro
Apr 9, 2004·Journal of Neurosurgery·Charlotte HöybyeAnders Anggård
May 6, 2004·The Journal of Clinical Endocrinology and Metabolism·Rosario PivonelloSteven W J Lamberts
Aug 7, 2004·European Journal of Endocrinology·Bruno AmbrosiPaolo Beck-Peccoz
Dec 8, 2004·The Journal of Clinical Endocrinology and Metabolism·Gary D HammerCharles B Wilson
Jun 16, 2005·The Journal of Clinical Endocrinology and Metabolism·Marco LocatelliEdward R Laws
Jul 21, 2005·Journal of Neurosurgery·Ronald J BenvenisteKalmon D Post
Jan 25, 2006·Clinical Endocrinology·Francesca Pecori GiraldiFrancesco Cavagnini
May 9, 2006·Trends in Endocrinology and Metabolism : TEM·Gherardo MazziottiAndrea Giustina
Jul 27, 2006·The Journal of Clinical Endocrinology and Metabolism·James W Findling, Hershel Raff
Aug 31, 2006·The Journal of Clinical Endocrinology and Metabolism·Dalia L BatistaAnne Klibanski

❮ Previous
Next ❯

Citations

Jan 15, 2014·Endocrine·Annamaria ColaoFelipe F Casanueva
Feb 26, 2016·Oncology Nursing Forum·Dan Louie Renz P TatingLoyda Cajucom
Sep 1, 2012·Expert Review of Endocrinology & Metabolism·Kelley J MoloneyMarc R Mayberg
Feb 26, 2013·Pharmacotherapy·Farah H Morgan, Marc J Laufgraben
Mar 1, 2013·Expert Review of Endocrinology & Metabolism·Farah H Morgan, Marc Laufgraben
Jun 12, 2013·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Sandeep AggarwalVrishketan Sethi
Oct 23, 2020·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·Julian B WilsonTheodore C Friedman
Oct 16, 2013·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Pejman Cohan

❮ Previous
Next ❯

Software Mentioned

IPSS

Related Concepts

Related Feeds

Addison Disease

Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.

Related Papers

Therapeutics and Clinical Risk Management
Tatiana ManciniAndrea Giustina
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme
Agata JuszczakAshley Grossman
© 2022 Meta ULC. All rights reserved