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[Bile excretion system in endogenous hypercorticism syndrome].

S V German, Z A Lemeshko, T Ia Vaĭnshteĭn

    Sovetskaia Meditsina
    |January 1, 1989
    PubMed
    Summary

    Patients with hypercorticism syndromes, including Itsenko-Cushing disease, frequently experience biliary disorders. Elevated corticosteroids are linked to gallbladder dysfunction and altered bile composition, increasing risks for gallstones.

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    Area of Science:

    • Endocrinology
    • Gastroenterology
    • Hepatology

    Context:

    • Endogenic hypercorticism syndrome, Itsenko-Cushing disease, and corticosteroma involve excess endogenous corticosteroids.
    • Biliary tract disorders are common but their specific association with hypercorticism requires further elucidation.
    • Understanding these associations is crucial for comprehensive patient management.

    Purpose:

    • To investigate bile excretion and biochemical properties in patients with hypercorticism.
    • To determine the incidence and nature of functional and organic biliary disorders in these patients.
    • To explore the relationship between adrenocortical hyperfunction and biliary system abnormalities.

    Summary:

    • A study of 86 patients with endogenic hypercorticism syndrome, 78 with Itsenko-Cushing disease, and 8 with corticosteroma revealed significant biliary issues.
    • Biliary disorders included impaired cholecyst contractility (54.6%), sphincter of Oddi hypotonus (65.6%), sphincter of Lutkens hypotonus (67.2%), chronic cholecystitis (70.9%), cholelithiasis (16.3%), and cholecyst cholesterosis (3.5%).
    • Adrenocortical hyperfunction correlated with increased bile cholesterol and decreased cholic acid and phospholipids, potentially promoting cholelithiasis.

    Impact:

    • The findings highlight a high prevalence of biliary disturbances in patients with hypercorticism.
    • Altered bile composition due to hypercorticism may predispose patients to gallstone formation.
    • These results emphasize the need to consider biliary health in the treatment protocols for hypercorticism patients.

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