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Related Concept Videos

Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

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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...
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Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

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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...
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Adrenal Gland Disorders01:27

Adrenal Gland Disorders

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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...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
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Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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Related Experiment Video

Updated: Apr 30, 2026

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
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Acute hypercortisolism: what can the surgeon offer?

Emily Davenport1, Tom Lennard

  • 1Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK.

Clinical Endocrinology
|May 8, 2014
PubMed
Summary

Acute hypercortisolism is a critical illness, often linked to cancer. While surgery is an option for resectable cases, its palliative role in unresectable disease requires further investigation.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Critical Care Medicine

Background:

  • Acute hypercortisolism is a rare, life-threatening condition necessitating urgent medical intervention.
  • Malignancy is the predominant cause, with surgical resection feasible only in a minority of patients.
  • Current medical management for unresectable disease is frequently insufficient, prompting exploration of surgical palliation.

Purpose of the Study:

  • To review the current understanding and management strategies for acute hypercortisolism.
  • To explore the controversial role of surgery in palliative care for patients with unresectable disease.
  • To highlight the complexities in decision-making for acute hypercortisolism cases.

Main Methods:

  • Literature review focusing on acute hypercortisolism and surgical palliation.

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  • Analysis of current controversies regarding patient selection, surgical timing, and technique.
  • Discussion of the need for specialized management settings.

    • Main Results:

    • The majority of acute hypercortisolism cases are associated with underlying malignancies.
    • Surgical intervention is primarily indicated for resectable tumors.
    • The efficacy and optimal application of surgery for palliative care in unresectable cases remain poorly defined.

    Conclusions:

    • Management of acute hypercortisolism is complex and challenging.
    • Further research is needed to clarify the role of surgery in palliative settings.
    • Subspecialized care is crucial for optimizing outcomes in patients with acute hypercortisolism.