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The Cushing syndromes.

K L Jones1

  • 1School of Medicine, University of California, San Diego, La Jolla.

Pediatric Clinics of North America
|December 1, 1990
PubMed
Summary
This summary is machine-generated.

Recent advances have significantly improved the understanding, diagnosis, and treatment of Cushing syndrome (CS). New diagnostic tools and surgical techniques offer more effective management for this complex hormonal disorder.

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Area of Science:

  • Endocrinology
  • Internal Medicine
  • Hormonal Disorders

Background:

  • Cushing syndrome (CS) encompasses a range of conditions affecting the hypothalamic-pituitary-adrenal (HPA) axis.
  • Over the past decade, significant progress has been made in understanding the diverse causes and manifestations of CS.

Purpose of the Study:

  • To review the advancements in the diagnosis and treatment of Cushing syndrome over the last 10 years.
  • To highlight the expanded understanding of the Cushing syndrome spectrum, including adrenal and ectopic ACTH-dependent causes.

Main Methods:

  • Utilized improved adrenocorticotropic hormone (ACTH) assays and corticotropin-releasing factor (CRF) for HPA axis assessment.
  • Employed advanced imaging technologies for visualizing pituitary and adrenal tumors.

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  • Incorporated selective catheterization and sampling techniques for diagnostic accuracy.
  • Reviewed the efficacy of refined transsphenoidal surgery for Cushing's disease (CD).

    • Main Results:

    • The spectrum of Cushing syndromes has expanded, including adrenal tumors, ectopic ACTH secretion, and autoimmune causes.
    • Enhanced diagnostic tools, including improved ACTH assays and imaging, have led to more accurate identification of CS causes.
    • Transsphenoidal surgery has proven a safe and effective treatment for Cushing's disease.
    • Pharmacological options decreasing steroid biosynthesis are available for medical management.

    Conclusions:

    • Our understanding of Cushing syndrome has markedly improved, leading to better diagnostic and therapeutic strategies.
    • Advances in molecular biology, imaging, and surgical techniques have transformed the management of CS.
    • Continued research is expected to further elucidate the complexities of Cushing syndrome.