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Cushing's disease cycling over ten years
V Popovic1, D Micic, M Nesovic
1Institute of Endocrinology, Diabetes Mellitus and Metabolism, Belgrade/Yugoslavia.
Experimental and Clinical Endocrinology
|November 1, 1990
Summary
This study details a patient with cyclical Cushing's syndrome due to a pituitary adenoma, experiencing long remission periods. It highlights a record 4.5-year remission and discusses diagnostic challenges in managing this rare endocrine disorder.
Area of Science:
- Endocrinology
- Neuroendocrinology
- Pituitary Disorders
Background:
- Cyclical Cushing's syndrome is characterized by intermittent hypercortisolism.
- Corticotroph pituitary adenomas are a common cause of Cushing's disease.
- Understanding the natural history and diagnostic challenges is crucial for patient management.
Observation:
- A 10-year follow-up of a patient with cyclical Cushing's syndrome caused by a corticotroph pituitary adenoma.
- The patient experienced four episodes of hypercortisolism, hypokalemia, and edema, interspersed with three spontaneous remissions.
- A notable finding was a 4.5-year remission phase, the longest recorded for this condition.
Findings:
- The study documents the longest spontaneous remission phase (4.5 years) in a patient with cyclical Cushing's syndrome.
- Recurrence of hypercortisolism was observed two months postpartum, suggesting potential triggers.
- Standard dynamic tests for diagnosing Cushing's syndrome may present diagnostic uncertainties in cyclical forms.
Implications:
- This case expands the understanding of the prolonged remission potential in cyclical Cushing's syndrome.
- Identifying triggers for recurrence, such as postpartum status, is vital for proactive management.
- Further research into refined diagnostic tools for cyclical Cushing's syndrome is warranted.
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