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Related Concept Videos

Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

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Updated: May 21, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

Cushing's disease.

Frederic Castinetti1, Isabelle Morange, Bernard Conte-Devolx

  • 1Department of Endocrinology and Reference Center for Rare Pituitary Diseases La Timone Hospital, Aix-Marseille University, Marseille, France. Frederic.castinetti@ap-hm.fr

Orphanet Journal of Rare Diseases
|June 20, 2012
PubMed
Summary
This summary is machine-generated.

Cushing's disease, a rare pituitary disorder, presents challenges in diagnosis and treatment. Transsphenoidal surgery offers high remission rates for microadenomas, but other therapies are needed for macroadenomas and to manage long-term hypercortisolism risks.

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

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A Novel Method: Super-selective Adrenal Venous Sampling
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Area of Science:

  • Endocrinology
  • Pituitary Disorders
  • Rare Diseases

Background:

  • Cushing's disease (pituitary ACTH-dependent Cushing's syndrome) is a rare endocrine disorder associated with significant morbidity and mortality.
  • Clinical signs of hypercortisolism, such as obesity, protein wasting, hypertension, and hirsutism, are often nonspecific, complicating diagnosis.
  • Effective management requires a structured diagnostic algorithm and timely therapeutic intervention.

Purpose of the Study:

  • To review the pathophysiological mechanisms underlying Cushing's disease.
  • To outline current diagnostic approaches for pituitary ACTH-dependent Cushing's syndrome.
  • To summarize therapeutic strategies, including surgical and medical options, for managing hypercortisolism.

Main Methods:

  • Literature review of pathophysiological mechanisms, diagnostic criteria, and treatment modalities for Cushing's disease.
  • Analysis of remission rates for different treatment approaches.
  • Discussion of long-term complication management.

Main Results:

  • Transsphenoidal surgery is the primary treatment, achieving an 80% cure rate for ACTH-secreting microadenomas.
  • Remission rates are lower for macroadenomas, necessitating alternative or adjuvant therapies.
  • Long-term risks of persistent hypercortisolism include metabolic syndrome, osteoporosis, and cardiovascular disease.

Conclusions:

  • Cushing's disease diagnosis is challenging due to nonspecific symptoms, requiring a strict algorithmic approach.
  • While surgery is effective for microadenomas, macroadenomas and persistent disease require multimodal treatment strategies.
  • Management aims to control hypercortisolism and mitigate severe long-term health consequences.