ACTH-dependent cushing’s syndrome: an overview of the clinical features, diagnosis and treatment in the endocrinology-diabetology and nutrition department of oujda’s mohammed vi university hospital - morocco

2020 ◽  
Author(s):  
Imane Assarrar ◽  
Khadija Boujtat ◽  
Wahiba Abdellaoui ◽  
Siham Rouf ◽  
Hanane Latrech
Keyword(s):  
Clinical Features ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
University Hospital ◽  
Diagnosis And Treatment

scholarly journals Cushing's syndrome associated with a nested stromal epithelial tumor of the liver: hormonal, immunohistochemical, and molecular studies

2009 ◽  
Vol 161 (5) ◽  
pp. 805-810 ◽  
Author(s):  
Anne Rod ◽  
Manuela Voicu ◽  
Laurence Chiche ◽  
Céline Bazille ◽  
Hervé Mittre ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Malignant Tumors ◽  
Cushing's Syndrome ◽  
Good Prognosis ◽  
University Hospital ◽  
Ectopic Acth Syndrome ◽  
Epithelial Tumor ◽  
Ectopic Acth ◽  
Normal Human

ContextEctopic ACTH syndrome (EAS) is principally associated with aggressive malignant tumors but also with neuroendocrine tumors of good prognosis. Recently, rare nonhepatocytic nested stromal and epithelial tumors (NSET) were characterized by their possible association with Cushing's syndrome of which biochemical and physiopathological features were still incompletely studied.ObjectiveTo describe the clinical and hormonal characteristics of an EAS originating from a liver NSET and further understand the mechanism of cortisol overproduction.Design and settingThis is a clinical case report from the Endocrinology Department of Caen University Hospital, France.Patient and interventionA 17-year-old female patient was found to have a large liver NSET with mild Cushingoid clinical features and intense biological hypercortisolism but moderate ACTH secretion. Resection of the tumor was curative with a 30-month follow-up.ResultsThe epithelial component of the tumor coexpressed ACTH mildly, corticotropin-releasing hormone (CRH) strongly, and 11β-hydroxysteroid dehydrogenase at a level comparable with normal human hepatocytes.ConclusionsLiver NSET is a new cause of EAS, which may evoke hypercortisolism by multiple biochemical pathways.

scholarly journals Classification, diagnosis and treatment of ACTH-independent macronodular adrenal hyperplasia

2013 ◽  
Vol 7 (9-10) ◽  
pp. 594 ◽  
Author(s):  
Heng-Chuan Su ◽  
Xin Huang ◽  
Jun Dai ◽  
Wen-long Zhou ◽  
Bao-xing Huang ◽  
...  
Keyword(s):  
High Risk ◽  
Cushing’S Syndrome ◽  
English Literature ◽  
Clinical Manifestations ◽  
Serum Cortisol ◽  
Cushing's Syndrome ◽  
Diagnosis And Treatment ◽  
Adrenal Hyperplasia ◽  
Treatment Methods ◽  
Future Therapy

ACTH-independent macronodular adrenal hyperplasia (AIMAH) is a distinctive subtype of Cushing’s syndrome (CS), with different clinical manifestations according to the level of serum cortisol. Based on clinical manifestations and serum cortisol, we divide AIMAH into three types, subclinical AIMAH, clinical AIMAH and high-risk AIMAH, with varied treatment methods being adapted to different subtypes. At the same time, we describe 3 patients who represent these subtypes of this disease, and review some cases of AIMAH which have been previously reported in the English literature. To our knowledge, this is the first article discussing classification, diagnosis and treatment of this disease and should be useful for future therapy of AIMAH.

scholarly journals Is There Value in Routine Screening for Cushing’s Syndrome in Patients with Diabetes?

2010 ◽  
Vol 95 (5) ◽  
pp. 2262-2265 ◽  
Author(s):  
K. Mullan ◽  
N. Black ◽  
A. Thiraviaraj ◽  
P. M. Bell ◽  
C. Burgess ◽  
...  
Keyword(s):  
Clinical Features ◽  
Cushing’S Syndrome ◽  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Cushing's Syndrome ◽  
Diabetic Patients ◽  
Diabetes Clinic ◽  
Free Cortisol ◽  
Cortisol Levels ◽  
Dexamethasone Test

Abstract Context: Subclinical Cushing’s syndrome has been described among diabetic populations in recent years, but no consensus has emerged about the value of screening. Methods: We enrolled 201 consecutive patients attending our diabetes clinic and 79 controls. Patients with at least two of the following three criteria were offered screening using a 2300 h salivary cortisol test: glycosylated hemoglobin of at least 7%, body mass index of at least 25 kg/m2, and a history of hypertension or blood pressure of at least 140/90 mm Hg. Results are expressed as mean ± sem. Results: Mean nighttime salivary cortisol levels were similar in the two groups (8.5 ± 1.0 nmol/liter for diabetic patients vs. 5.8 ± 1.0 nmol/liter for controls). Forty-seven patients (23%) had a value of at least 10 nmol/liter, which was set as a conservative threshold above which further investigation would be performed. Thirty-five (75%) agreed to further testing with a 1-mg overnight dexamethasone test. Of the remaining 12 patients, 10 were followed up clinically for at least 1 yr, and no evidence was found of the syndrome evolving. In 28 patients, serum cortisol suppressed to 60 nmol/liter or less. Of the seven patients who failed this test, four agreed to a 2 mg/d 48-h dexamethasone test, with serum cortisol suppressing to 60 nmol/liter or less in all four. Three declined this test but had normal 24-h urinary free cortisol levels. No patient had clinical features of hypercortisolism. Conclusions: The 1–3% detection rates of three recently published series have not been realized at our center where we studied a group using criteria making patients more likely to have hypercortisolism. Our results do not support the validity of screening patients without clinical features of Cushing’s syndrome in the diabetes clinic.

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