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[Endogenous hypercortisolism and immunologically-mediated disease: three cases].

R Sahli¹, P Diem, E R Christ

¹Department of Endocrinology, University Hospital of Berne, Inselspital, Bern.

Deutsche Medizinische Wochenschrift (1946)

|October 19, 2005

Summary

Successful Cushing's syndrome treatment can trigger autoimmune conditions like Graves' disease. Monitoring immune-mediated diseases aids in diagnosing and managing hypercortisolism.

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Area of Science:

Endocrinology
Immunology

Background:

Cushing's syndrome, characterized by hypercortisolism, presents with diverse clinical manifestations.
Coexisting immunologically mediated diseases can influence the presentation and diagnosis of endocrine disorders.

Observation:

Three women with Cushing's syndrome experienced amelioration of atopic dermatitis and psoriasis during hypercortisolism.
Post-treatment for hypercortisolism, these dermatological conditions recurred, and one patient developed Graves' disease.

Findings:

Diagnosis involved dexamethasone suppression tests, 24-hour urine cortisol, ACTH levels, CRH stimulation, petrosal sinus sampling, and imaging.
Successful surgical treatment (adrenalectomy or hypophysectomy) resolved hypercortisolism symptoms.

Implications:

Related Experiment Videos

Successful treatment of endogenous hypercortisolism may unmask or trigger other immunologically mediated conditions, particularly autoimmune thyroiditis.
The course of immune-mediated diseases can serve as a diagnostic aid and monitoring tool for Cushing's syndrome patients post-surgery.