Oligohydramnios in a pregnant woman with Cushing's syndrome caused by an adrenocortical adenoma

2007 ◽  
Vol 20 (5) ◽  
pp. 431-434 ◽  
Author(s):  
Pieter C. M. De Groot ◽  
Inge L. Van Kamp ◽  
Evert J. K. Zweers ◽  
Cor D. De Kroon ◽  
Willem J. Van Wijngaarden
Keyword(s):  
Pregnant Woman ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma

High [18F] 2-fluoro-2-deoxy-d-glucose (FDG) uptake of adrenocortical adenoma showing subclinical Cushing's syndrome

2003 ◽  
Vol 17 (5) ◽  
pp. 403-406 ◽  
Author(s):  
Akiko Shimizu ◽  
Noboru Oriuchi ◽  
Yoshito Tsushima ◽  
Tetsuya Higuchi ◽  
Jun Aoki ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Subclinical Cushing’S Syndrome ◽  
Fdg Uptake

scholarly journals Reversible alterations in cardiac morphology and functions in a patient with Cushing's syndrome

2014 ◽  
Vol 2014 ◽  
Author(s):  
Hiroaki Iwasaki
Keyword(s):  
Cushing’S Syndrome ◽  
Interventricular Septum ◽  
Urinary Free Cortisol ◽  
Cushing's Syndrome ◽  
Left Ventricular ◽  
Multidetector Row Computed Tomography ◽  
List Type ◽  
Adrenocortical Adenoma ◽  
Cardiac Morphology ◽  
Free Cortisol

Summary A 45-year-old female was referred for endocrine evaluation of an incidental mass (31×24 mm in diameter) on the right adrenal gland. The patient was normotensive and nondiabetic, and had no history of generalised obesity (body weight, 46 kg at 20 years of age and 51.2 kg on admission); however, her waist-to-hip ratio was 0.97. Elevated urinary free cortisol levels (112–118 μg/day) and other findings indicated adrenocorticotrophic hormone-independent Cushing's syndrome due to right adrenocortical adenoma. Echocardiography before adrenalectomy revealed concentric left ventricular (LV) hypertrophy with a particular increase in interventricular septum thickness leading to impaired systolic and diastolic functions. Upon surgical remission of hypercortisolism, the asymmetric hypertrophy disappeared and the cardiac dysfunctions were considerably ameliorated. Although the mechanism(s) by which excessive cortisol contributes to LV wall thickness remain(s) unclear, serial echocardiography and cardiac multidetector-row computed tomography may support the notion that abnormal fat deposition in the myocardium owing to hypercortisolism appears to be an important factor for the reversible change in the cardiac morphology. Learning points Patients with Cushing's syndrome occasionally exhibit severe LV hypertrophy related to systolic and diastolic dysfunctions although they have neither hypertension nor diabetes mellitus. Biological remission of hypercortisolism can normalise structural and functional cardiac parameters and help in differentiating the cardiac alterations induced by excessive cortisol from those induced by other diseases. Excessive lipid accumulation within the heart before myocardial fibrosis may be implicated in reversible alterations in the cardiac morphology by Cushing's syndrome. Early diagnosis and treatment of Cushing's syndrome appear to be pivotal in preventing irreversible cardiac dysfunctions subsequent to cardiovascular events and heart failure.

scholarly journals Phase-shifted Diurnal Rhythm of Cortisol Secretion in a Patient with Cushing's Syndrome due to Adrenocortical Adenoma.

1988 ◽  
Vol 35 (2) ◽  
pp. 261-266
Author(s):  
AKIRA SHIMATSU ◽  
YUZURU KATO ◽  
HIDETA SAKAMI ◽  
YOSHIKATSU NAKAI ◽  
HIROO IMURA
Keyword(s):  
Cushing’S Syndrome ◽  
Diurnal Rhythm ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Cortisol Secretion

Properties of partially purified thymidine kinase in adrenal tissue of hyperplasia, adenomatous hyperplasia, adenoma and carcinoma of patients with Cushing's syndrome.

1980 ◽  
Vol 93 (2) ◽  
pp. 208-215 ◽  
Author(s):  
Hajime Nawata ◽  
Ken-ichi Kato ◽  
Hiroshi Ibayashi
Keyword(s):  
Adrenal Gland ◽  
Thymidine Kinase ◽  
Cushing’S Syndrome ◽  
Adrenocortical Carcinoma ◽  
Catalytic Properties ◽  
Deae Cellulose ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Adenomatous Hyperplasia ◽  
Adrenocortical Hyperplasia

Abstract. Thymidine kinase (TK) was partially purified from adrenal tissues with adrenocortical hyperplasia, adenomatous hyperplasia, adenoma and carcinoma from patients with Cushing's syndrome and from normal adrenal glands. Adrenocortical carcinoma, adenoma, hyperplasia and nodule and hyperplastic portion of adenomatous hyperplasia contained higher concentration of TK than normal adrenal gland. By DEAE-cellulose column chromatography, adrenocortical carcinoma gave two peaks (Peak I and Peak II) of TK, while in other adrenal tissues the second peak (Peak II) was only slightly detected or hardly detected. TK in all these tissues was identical with respect to pH optimum, metal requirement and inhibition by dTTP. dCTP inhibited TK activities of normal adrenal gland and the hyperplastic portion of adenomatous hyperplasia by 55%, respectively, but hardly affected the activity of the nodule of adenomatous hyperplasia, adenoma, hyperplasia and carcinoma. TK from hyperplastic portion of adenomatous hyperplasia showed the intermediate heat stability between the heat-stable enzyme from normal adrenal gland and the heat-labile enzyme from adrenocortical carcinoma, adenoma, hyperplasia and the nodule of adenomatous hyperplasia. The apparent Km for thymidine from adenocortical carcinoma (Peak I and Peak II) was 5.0 and 11.1; adenoma, 4.8; hyperplasia, 5.5; adenomatous hyperplasia (nodule, 5.0 and hyperplastic portion, 19.8) and normal adrenal gland, 25.0 μm. These observations indicated that TK with different catalytic properties existed in various human adrenal tissues. They also demonstrated that TK isolated from the nodule of adrenocortical adenomatous hyperplasia had similar properties as adrenocortical adenoma, while TK from the hyperplastic portion had the intermediate catalytic properties between normal adrenal gland and adrenocortical hyperplasia.

scholarly journals Perioperative Endocrine Therapy for Patients with Cushing's Syndrome Undergoing Retroperitoneal Laparoscopic Adrenalectomy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaobo Cui ◽  
Lu Yang ◽  
Jianwei Li ◽  
Siyuan Bu ◽  
Qiang Wei ◽  
...  
Keyword(s):  
Endocrine Therapy ◽  
Cushing’S Syndrome ◽  
Laparoscopic Adrenalectomy ◽  
Clinical Manifestations ◽  
Perioperative Period ◽  
Serum Cortisol ◽  
Serum Levels ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Hospital Days

Objectives. To investigate the efficacy and safety of perioperative endocrine therapy (PET) for patients with Cushing’s syndrome (CS) undergoing retroperitoneal laparoscopic adrenalectomy (RLA).Methods. The novel, simplified PET modality of 82 patients who underwent RLA procedures for CS were studied. Clinical manifestations were observed for all patients on days 1 and 5 postoperatively, and clinical data, such as blood pressure (BP), levels of serum cortisol, adrenocorticotropin (ACTH), blood glucose, and electrolytes, were acquired and analyzed.Results. Supraphysiological doses of glucocorticoid were administered during the perioperative period, and the dosage was reduced gradually. In all 82 cases, the RLAs were performed successfully without any perioperative complication, such as steroid withdrawal symptoms. The patient’s symptoms and signs were improved quickly and safely during the hospital days. The serum cortisol and potassium levels were rather stable on days 1 and 5 postoperatively, and most were within the normal range. The clinical manifestations, serum levels of cortisol, ACTH, and potassium in most patients restored to normal gradually after several months (mean, 6.7 ± 1.2 months), except for one patient undergoing bilateral adrenalectomy.Conclusions. This perioperative endocrine therapy for patients with Cushing’s syndrome (mainly for adrenocortical adenoma) undergoing retro-laparoscopic adrenalectomy is both effective and safe.

scholarly journals Clinical Characteristics of Endogenous Cushing’s Syndrome at a Medical Center in Southern Taiwan

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Shih-Chen Tung ◽  
Pei-Wen Wang ◽  
Rue-Tsuan Liu ◽  
Jung-Fu Chen ◽  
Ching-Jung Hsieh ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cushing’S Syndrome ◽  
Plasma Cortisol ◽  
Medical Center ◽  
Cushing's Syndrome ◽  
Dexamethasone Suppression Test ◽  
Adrenocortical Adenoma ◽  
Suppression Test ◽  
Southern Taiwan ◽  
Dexamethasone Suppression

From January 1987 to December 2011, over a total of 25 years, 84 patients with Cushing’s syndrome (CS) were identified at a medical center in southern Taiwan. We observed a higher incidence of ACTH-independent CS (75%) than ACTH-dependent CS (25%). A higher incidence of adrenocortical adenoma (58.3%) than Cushing’s disease (CD, 21.4%) was also found. The sensitivity of the definitive diagnostic tests for CS, including loss of plasma cortisol circadian rhythm, a baseline 24 h urinary free cortisol (UFC) value >80 μg, and overnight and 2-day low-dose dexamethasone suppression test, was between 94.4% and 100%. For the 2-day high-dose dexamethasone suppression test for the differential diagnosis of CD, the sensitivity of 0800 h plasma cortisol and 24 h UFC was 44.4% and 85.7%, respectively. For the differential diagnosis of adrenal CS, the sensitivities of the 0800 h plasma cortisol and 24 h UFC were 95.5% and 88.9%, respectively. In patients with ACTH-independent CS and ACTH-dependent CS, the baseline plasma ACTH levels were all below 29 pg/mL and above 37 pg/mL, respectively. The postsurgical hospitalization stay following retroperitoneoscopic adrenalectomy was shorter than that observed for transabdominal adrenalectomy (4.3 ± 1.6 versus 8.8 ± 3.7 days,P<0.001). It was easy to develop retroperitoneal and peritoneal seeding of adrenocortical carcinoma via laparoscopic adrenalectomy.

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