THE CORRELATION BETWEEN ENDOCRINE EXOPHTHALMOS AND EXOPHTHALMOS PRODUCING SUBSTANCE (EPS)

1966 ◽  
Vol 51 (3) ◽  
pp. 359-368 ◽  
Author(s):  
F. Schwarz ◽  
P. J. der Kinderen ◽  
Maria Houtstra-Lanz
Keyword(s):  
Cushing’S Syndrome ◽  
Anterior Pituitary ◽  
Pituitary Surgery ◽  
Normal Subjects ◽  
Serum Levels ◽  
Cushing's Syndrome ◽  
Graves Disease ◽  
Better Than

ABSTRACT The correlation between Endocrine Exophthalmos and serum levels of EPS was investigated in 64 exophthalmic patients; only 2 patients had no demonstrable EPS in their serum. 31 of these patients were suffering from thyrotoxicosis, 11 from Cushing's syndrome and 2 from acromegaly. 20 were euthyroid. The serum of 44 non-exophthalmic subjects was tested: 11 with thyrotoxicosis, 6 with Cushing's syndrome, 4 acromegalics and 23 normal subjects. Only in two of the non-exophthalmic thyrotoxics EPS was found in the serum. Both developed severe ophthalmopathy later in the course of the disease. In all groups of patients a fair correlation was found between the severity of the exophthalmos and EPS levels in the serum. In 8 patients, EPS levels were determined serially during the course of the disease, in some before as well as after pituitary surgery or irradiation. Changes in the EPS levels, corresponded well with the course of the ophthalmopathy. The correlation was better than that reported by some other investigators. In the authors opinion, these divergencies can be explained by differences in the method of EPS determination used. It is concluded that it is very probable that endocrine exophthalmos in Graves' disease as well as in Cushing's syndrome and in acromegaly, is caused by an anterior pituitary factor (EPS).

GASCHROMATOGRAPHIC DETERMINATION OF STEROIDS IN THE URINE OF PATIENTS WITH CUSHING'S SYNDROME

1971 ◽  
Vol 67 (2) ◽  
pp. 303-315 ◽  
Author(s):  
A. J. Moolenaar ◽  
A. P. van Seters
Keyword(s):  
Liquid Chromatography ◽  
Cushing’S Syndrome ◽  
Normal Subjects ◽  
Diagnostic Value ◽  
Cushing's Syndrome ◽  
Gas Liquid Chromatography ◽  
Obese Subjects

ABSTRACT The 17-oxosteroids were estimated in the urine of 27 patients with Cushing's syndrome by gas-liquid chromatography (G. L. C.). The values of the various steroid fractions are compared with those of normal subjects, patients with thyrotoxicosis and obese subjects. The effect of the age of the patients on the diagnostic value of the invidual 17-oxosteroids and their ratios is discussed.

SIMPLIFIED DEXAMETHASONE SUPPRESSION TEST

1969 ◽  
Vol 61 (2) ◽  
pp. 219-231 ◽  
Author(s):  
V. H. Asfeldt
Keyword(s):  
Cushing’S Syndrome ◽  
Normal Subjects ◽  
Cushing's Syndrome ◽  
Dexamethasone Suppression Test ◽  
Clinical Value ◽  
Suppression Test ◽  
The One ◽  
Steroid Excretion ◽  
Dexamethasone Suppression

ABSTRACT This is an investigation of the practical clinical value of the one mg dexamethasone suppression test of Nugent et al. (1963). The results, evaluated from the decrease in fluorimetrically determined plasma corticosteroids in normal subjects, as well as in cases of exogenous obesity, hirsutism and in Cushing's syndrome, confirm the findings reported in previous studies. Plasma corticosteroid reduction after one mg of dexamethasone in cases of stable diabetes was not significantly different from that observed in control subjects, but in one third of the insulin-treated diabetics only a partial response was observed, indicating a slight hypercorticism in these patients. An insufficient decrease in plasma corticosteroids was observed in certain other conditions (anorexia nervosa, pituitary adenoma, patients receiving contraceptive or anticonvulsive treatment) with no hypercorticism. The physiological significance of these findings is discussed. It is concluded that the test, together with a determination of the basal urinary 17-ketogenic steroid excretion, is suitable as the first diagnostic test in patients in whom Cushing's syndrome is suspected. In cases of insufficient suppression of plasma corticosteroids, further studies, including the suppression test of Liddle (1960), must be carried out.

SKIN-FOLD THICKNESS IN NORMAL SUBJECTS AND IN PATIENTS WITH ACROMEGALY AND CUSHING'S SYNDROME

1969 ◽  
Vol 60 (4) ◽  
pp. 705-711 ◽  
Author(s):  
A. D. Wright ◽  
G. F. Joplin
Keyword(s):  
Cushing’S Syndrome ◽  
Normal Subjects ◽  
Cushing's Syndrome ◽  
Normal Range ◽  
Clinical Method ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Normal Mean ◽  
The Mean ◽  
Age And Sex

ABSTRACT A simple clinical method of determining the skin-fold thickness on the dorsum of the hand has been described using the Harpendon spring-loaded caliper. A normal range for age and sex has been established in 258 normal subjects. The mean skin-fold thickness was greater in men than in women, and in both decreased with age, falling from 2.85 to 1.75 mm in men, and from 2.65 to 1.60 mm in women (aged 15–20 to 70–80). In 48 acromegalic patients, 71 % of the skin-fold measurements were abnormally thick. In 12 patients with Cushing's syndrome, although all measurements were below the normal mean, 42 % only were abnormally thin.

FEHLENDER ANSTIEG DER CORTICOSTEROIDE IM PLASMA WÄHREND DER INSULINHYPOGLYKÄMIE BEIM CUSHING-SYNDROM

1966 ◽  
Vol 51 (2) ◽  
pp. 166-174 ◽  
Author(s):  
H. Bethge ◽  
W. Winkelmann ◽  
H. Zimmermann
Keyword(s):  
Plasma Level ◽  
Cushing’S Syndrome ◽  
Normal Subjects ◽  
Cushing's Syndrome ◽  
Adrenal Hyperplasia ◽  
Acth Secretion ◽  
Initial Value ◽  
Stressful Stimulus ◽  
Acth Release

ABSTRACT Four patients with Cushing's syndrome associated with adrenal hyperplasia were submitted to insulin-induced liypoglycaemia. It was shown that contrary to conditions in normal subjects the Cushing-patients failed to respond to hypoglycaemia with an increase of corticosteroids in plasma. This effect was independent of the initial value of corticoid level. It is concluded that pituitary ACTH-release during hypoglycaemia in patients with Cushing's syndrome did not markedly increase. The findings are discussed under the aspects of primary hypothalamic pathogenesis of Cushing's syndrome: ACTH-secretion and plasma level are constant throughout the day and widely independent from exogenous and endogenous influences including such a stressful stimulus as hypoglycaemia.

Serum levels of calcitonin in Cushing’s syndrome

1986 ◽  
Vol 9 (3) ◽  
pp. 239-241 ◽  
Author(s):  
Giovanni Luisetto ◽  
F. Mantero ◽  
M. Boscaro ◽  
L. Tizian ◽  
M. Zangari ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Serum Levels ◽  
Cushing's Syndrome

Cushing's syndrome and autonomous thyroid nodules, a variant of multiple endocrine neoplasia?

1986 ◽  
Vol 113 (3) ◽  
pp. 463-464 ◽  
Author(s):  
C. G. Semple ◽  
J. A. Thomson
Keyword(s):  
Thyroid Nodule ◽  
Cushing’S Syndrome ◽  
Multiple Endocrine Neoplasia ◽  
Thyroid Nodules ◽  
Cushing Syndrome ◽  
Cushing's Syndrome ◽  
Graves Disease ◽  
Endocrine Neoplasia ◽  
Solitary Thyroid Nodule ◽  
Autonomous Thyroid Nodule

Abstract. Over a 20 year period 4 of 40 (10%) female patients with Cushing' syndrome also had a solitary thyroid nodule. In 3 cases this was an autonomous 'hot' nodule. In the same population only one case of presumed Graves' disease was seen. It is postulated that the association of autonomous thyroid nodule and Cushing's syndrome may represent a variant of multiple endocrine neoplasia.

scholarly journals Steroid withdrawal syndrome after successful treatment of Cushing’s syndrome: a reminder

2005 ◽  
Vol 153 (2) ◽  
pp. 207-210 ◽  
Author(s):  
A Bhattacharyya ◽  
K Kaushal ◽  
D J Tymms ◽  
J R E Davis
Keyword(s):  
Adrenal Insufficiency ◽  
Replacement Therapy ◽  
Cushing’S Syndrome ◽  
Withdrawal Syndrome ◽  
Pituitary Surgery ◽  
Cushing's Syndrome ◽  
Temporary Increase ◽  
Steroid Withdrawal ◽  
Glucocorticoid Replacement Therapy ◽  
Cortisol Levels

Steroid withdrawal syndrome (SWS) usually refers to relapse of the disease being treated after withdrawal of glucocorticoid therapy, or the symptoms of adrenal insufficiency which occur when glucocorticoids are rapidly reduced or stopped. A less well-recognised form of SWS is that which develops when patients experience a symptom complex similar to that of adrenal insufficiency despite acceptable cortisol levels. We describe three patients who presented with this form of SWS following surgical treatment for endogenous Cushing’s syndrome. All responded well to a short-term increase in the dose of glucocorticoid replacement therapy, with the median duration of the syndrome being 10 months (range 6–10 months). Trough serum cortisol levels above 100 nmol/l, with peaks between 460 and 750 nmol/l were documented in the first two patients at presentation with SWS. It is thought that the syndrome may result from development of tolerance to glucocorticoids, and mediators considered to be important in its development include interleukin-6, corticotrophin-releasing hormone, vasopressin, and central noradrenergic and dopaminergic systems. The exact underlying mechanism for SWS remains unclear. However, with increasing recommendations for use of lower doses of replacement glucocorticoids, its incidence may increase. Physicians need to be aware of this condition, which is self-limiting and easily treated by a temporary increase in the dose of glucocorticoid replacement therapy. It is possible that a slower glucocorticoid tapering regimen than that used in the standard postoperative management of patients undergoing pituitary surgery may reduce the risk of development of SWS.

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.

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