scholarly journals Psychiatric symptoms as a clinical presentation of Cushing’s syndrome

2013 ◽  
Vol 12 (1) ◽  
pp. 23 ◽  
Author(s):  
Alice Tang ◽  
Anthony J O’Sullivan ◽  
Terry Diamond ◽  
Andrew Gerard ◽  
Peter Campbell
Keyword(s):  
Cushing’S Syndrome ◽  
Clinical Presentation ◽  
Psychiatric Symptoms ◽  
Cushing's Syndrome

scholarly journals Mania as Debut of Cushing’s Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Ricardo Álvarez Martínez ◽  
Rosa María Tomé Rodríguez ◽  
María Álvarez Ariza ◽  
Carlos Spuch ◽  
Jose M. Olivares
Keyword(s):  
Cushing’S Syndrome ◽  
Clinical Condition ◽  
Psychiatric Symptoms ◽  
Cushing Syndrome ◽  
Cushing's Syndrome ◽  
Psychological Reaction

This is a case of a patient affected by Cushing syndrome that was admitted at the hospital due to hormonal problems. He had presented psychiatric symptoms that were mistakenly considered not directly connected to the pathology causing the clinical condition, but a mere psychological reaction to it.

Psychiatric Symptoms in Patients with Cushing’s Syndrome: Prevalence, Diagnosis and Management

Drugs ◽  
2017 ◽  
Vol 77 (8) ◽  
pp. 829-842 ◽  
Author(s):  
Alicia Santos ◽  
Eugenia Resmini ◽  
Juan Carlos Pascual ◽  
Iris Crespo ◽  
Susan M. Webb
Keyword(s):  
Cushing’S Syndrome ◽  
Psychiatric Symptoms ◽  
Cushing's Syndrome ◽  
Diagnosis And Management

scholarly journals Merits and pitfalls of mifepristone in Cushing's syndrome

2009 ◽  
Vol 160 (6) ◽  
pp. 1003-1010 ◽  
Author(s):  
F Castinetti ◽  
M Fassnacht ◽  
S Johanssen ◽  
M Terzolo ◽  
P Bouchard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Adrenal Insufficiency ◽  
Cushing’S Syndrome ◽  
Psychiatric Symptoms ◽  
Clinical Signs ◽  
Cushing's Syndrome ◽  
Close Monitoring ◽  
Ectopic Acth ◽  
Ectopic Acth Secretion ◽  
Glucose Levels

ObjectiveMifepristone is the only available glucocorticoid receptor antagonist. Only few adult patients with hypercortisolism were treated to date by this drug. Our objective was to determine effectiveness and tolerability of mifepristone in Cushing's syndrome (CS).DesignRetrospective study of patients treated in seven European centers.MethodsTwenty patients with malignant (n=15, 12 with adrenocortical carcinoma, three with ectopic ACTH secretion) or benign (n=5, four with Cushing's disease, one with bilateral adrenal hyperplasia) CS were treated with mifepristone. Mifepristone was initiated with a median starting dose of 400 mg/day (200–1000). Median treatment duration was 2 months (0.25–21) for malignant CS, and 6 months (0.5–24) for benign CS. Clinical (signs of hypercortisolism, blood pressure, signs of adrenal insufficiency), and biochemical parameters (serum potassium and glucose) were evaluated.ResultsTreatment was stopped in one patient after 1 week due to severe uncontrolled hypokalemia. Improvement of clinical signs was observed in 11/15 patients with malignant CS (73%), and 4/5 patients with benign CS (80%). Psychiatric symptoms improved in 4/5 patients within the first week. Blood glucose levels improved in 4/7 patients. Signs of adrenal insufficiency were observed in 3/20 patients. Moderate to severe hypokalemia was observed in 11/20 patients and increased blood pressure levels in 3/20 patients.ConclusionMifepristone is a rapidly effective treatment of hypercortisolism, but requires close monitoring of potentially severe hypokalemia, hypertension, and clinical signs of adrenal insufficiency. Mifepristone provides a valuable treatment option in patients with severe CS when surgery is unsuccessful or impossible.

scholarly journals The European Registry on Cushing's syndrome: 2-year experience. Baseline demographic and clinical characteristics

2011 ◽  
Vol 165 (3) ◽  
pp. 383-392 ◽  
Author(s):  
Elena Valassi ◽  
Alicia Santos ◽  
Maria Yaneva ◽  
Miklós Tóth ◽  
Christian J Strasburger ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Clinical Presentation ◽  
Cushing's Syndrome ◽  
The Other ◽  
European Level ◽  
Scale Scores ◽  
Design And Methods ◽  
European Registry ◽  
Baseline Demographic

ObjectiveThe European Registry on Cushing's syndrome (ERCUSYN) is designed to collect prospective and follow-up data at EU level on Cushing's syndrome (CS).Design and methodsBaseline data on 481 CS patients (390 females, 91 males; mean age (±s.d.): 44±14 years) collected from 36 centres in 23 countries, including new patients from 2008 and retrospective cases since 2000. Patients were divided into four major aetiologic groups: pituitary-dependent CS (PIT-CS) (66%), adrenal-dependent CS (ADR-CS) (27%), CS from an ectopic source (ECT-CS) (5%) and CS from other aetiologies (2%).ResultsProportion of men in the ECT-CS group was higher than in the other groups (P<0.05). The ADR-CS group was older than the PIT-CS (P<0.05). Prevalence of hirsutism (92%) and diabetes (74%) in ECT-CS was higher than in the other groups (P<0.05 and P<0.01 respectively). PIT-CS had more skin alterations, menstrual irregularities and hirsutism than ADR-CS (P<0.01). Reduced libido was more prevalent in men than women (P<0.01). Prevalence of spine osteoporosis was higher in men than women (P<0.05), and males had more vertebral and rib fractures than females (52 vs 18% for vertebrae; P<0.001 and 34 vs 23% for ribs; P<0.05). ECT-CS consulted a diabetologist more frequently than ADR-CS (P<0.05), while a gynaecologist was consulted more often by women with PIT-CS or ADR-CS than with ECT-CS (P<0.05). Overall, weight gain was more common in women than men (P<0.01). CushingQoL and EuroQoL visual analogue scale scores did not differ between the groups.ConclusionsThe ERCUSYN project demonstrates a heterogeneous clinical presentation of CS at a European level, depending on gender and aetiology.

scholarly journals DYNAMICS OF PSYCHIATRIC SYMPTOMS IN CUSHING’S SYNDROME

2020 ◽  
Vol 26 (4) ◽  
pp. 3443-3448
Author(s):  
Tatyana Telbizova ◽  
◽  
Ivan Aleksandrov ◽  
Mariana Arnaoudova ◽  
◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Psychiatric Symptoms ◽  
Adrenal Adenoma ◽  
Dynamic Change ◽  
Antidepressant Medication ◽  
Cushing's Syndrome ◽  
Successful Outcome ◽  
Atypical Depression ◽  
Atypical Symptoms ◽  
Cortisol Levels

Cushing’s syndrome may present with various psychiatric disorders which can lead to a misdiagnosis at the beginning, deterioration of the course of the disease and life-threatening complications. The most common psychiatric disorder is atypical depression. During the initial stages of the disease, the somatic symptoms of Cushing’s syndrome can be subtle, difficult to identify, especially when the psychiatric symptoms are dominant. Objective: The aim of the present article is to report a case of a 24-year-old woman with a Cushing’s syndrome, caused by the adrenal adenoma. The onset of the disease is a suicidal attempt. Family history is significant for psychiatry disorder. The belated diagnosis led to somatic and psychiatry complications of the disease – sepsis and persisting high suicidal risk. The dynamic change in the patient’s mental state – from a severe depressive episode with atypical symptoms to psychosis with single catatonic symptoms – correlated well with the gradual increase of the plasma cortisol levels. The antidepressant and subsequent antipsychotic medication turned out to be ineffective. The surgical treatment, followed by a normalization of the cortisol levels was a key to the successful outcome and the reduction of self-aggression risk. Conclusion: The early diagnosis and timely treatment of Cushing’s syndrome decrease the risk of multiple complications. The shift from atypical depression to psychosis with catatonic symptoms correlates with the worsening of the hormonal imbalance. The signs of atypical depression in Cushing's syndrome, resistant to the antidepressant medication, could be considered as relatively specific symptoms, guiding specialists to its somatogenic origin for the proper diagnosis.

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