Skip to main content
Erschienen in: Pituitary 2/2015

01.04.2015

Clinical and biochemical manifestations of Cushing’s

verfasst von: Georgia Ntali, Ashley Grossman, Niki Karavitaki

Erschienen in: Pituitary | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Cushing’s syndrome is associated with a number of clinical manifestations and co-morbidities which may not resolve even after long-term remission leading to excessive mortality.

Materials and methods

This review summarizes the main manifestations of Cushing’s syndrome (active or in remission) with particular focus on data from recently published literature.

Conclusion

Obesity and metabolic alterations, hypertension and cardio/cerebrovascular complications, hypercoagulability/thromboembolism, neuropsychiatric, muscle/skeletal and immune consequences remain the most challenging. Cardiovascular consequences and immunosuppression determine the main causes of death in Cushing’s syndrome necessitating early intervention when possible.
Literatur
1.
Zurück zum Zitat Ntali G, Asimakopoulou A, Siamatras T, Komninos J, Vassiliadi D, Tzanela M, Tsagarakis S, Grossman AB, Wass JA, Karavitaki N (2013) Mortality in Cushing’s syndrome: systematic analysis of a large series with prolonged follow-up. Eur J Endocrinol 169:715–723CrossRefPubMed Ntali G, Asimakopoulou A, Siamatras T, Komninos J, Vassiliadi D, Tzanela M, Tsagarakis S, Grossman AB, Wass JA, Karavitaki N (2013) Mortality in Cushing’s syndrome: systematic analysis of a large series with prolonged follow-up. Eur J Endocrinol 169:715–723CrossRefPubMed
2.
Zurück zum Zitat Yaneva M, Kalinov K, Zacharieva S (2013) Mortality in Cushing’s syndrome: data from 386 patients from a single tertiary referral center. Eur J Endocrinol 169:621–627CrossRefPubMed Yaneva M, Kalinov K, Zacharieva S (2013) Mortality in Cushing’s syndrome: data from 386 patients from a single tertiary referral center. Eur J Endocrinol 169:621–627CrossRefPubMed
3.
Zurück zum Zitat Hassan-Smith ZK, Sherlock M, Reulen RC, Arlt W, Ayuk J, Toogood AA, Cooper MS, Johnson AP, Stewart PM (2012) Outcome of Cushing’s disease following transsphenoidal surgery in a single center over 20 years. J Clin Endocrinol Metab 97:1194–1201CrossRefPubMed Hassan-Smith ZK, Sherlock M, Reulen RC, Arlt W, Ayuk J, Toogood AA, Cooper MS, Johnson AP, Stewart PM (2012) Outcome of Cushing’s disease following transsphenoidal surgery in a single center over 20 years. J Clin Endocrinol Metab 97:1194–1201CrossRefPubMed
4.
Zurück zum Zitat Clayton RN, Raskauskiene D, Reulen RC, Jones PW (2011) Mortality and morbidity in Cushing’s disease over 50 years in Stoke-on-Trent, UK: audit and meta-analysis of literature. J Clin Endocrinol Metab 96:632–642CrossRefPubMed Clayton RN, Raskauskiene D, Reulen RC, Jones PW (2011) Mortality and morbidity in Cushing’s disease over 50 years in Stoke-on-Trent, UK: audit and meta-analysis of literature. J Clin Endocrinol Metab 96:632–642CrossRefPubMed
5.
Zurück zum Zitat Valassi E, Santos A, Yaneva M, Tóth M, Strasburger CJ, Chanson P, Wass JA, Chabre O, Pfeifer M, Feelders RA, Tsagarakis S, Trainer PJ, Franz H, Zopf K, Zacharieva S, Lamberts SW, Tabarin A, Webb SM, ERCUSYN Study Group (2011) The European Registry on Cushing’s syndrome: 2-year experience. Baseline demographic and clinical characteristics. Eur J Endocrinol 165:383–392CrossRefPubMed Valassi E, Santos A, Yaneva M, Tóth M, Strasburger CJ, Chanson P, Wass JA, Chabre O, Pfeifer M, Feelders RA, Tsagarakis S, Trainer PJ, Franz H, Zopf K, Zacharieva S, Lamberts SW, Tabarin A, Webb SM, ERCUSYN Study Group (2011) The European Registry on Cushing’s syndrome: 2-year experience. Baseline demographic and clinical characteristics. Eur J Endocrinol 165:383–392CrossRefPubMed
6.
Zurück zum Zitat Geer EB, Shen W, Gallagher D, Punyanitya M, Looker HC, Post KD, Freda PU (2010) MRI assessment of lean and adipose tissue distribution in female patients with Cushing’s disease. Clin Endocrinol 73:469–475 Geer EB, Shen W, Gallagher D, Punyanitya M, Looker HC, Post KD, Freda PU (2010) MRI assessment of lean and adipose tissue distribution in female patients with Cushing’s disease. Clin Endocrinol 73:469–475
7.
Zurück zum Zitat Kola B, Christ-Crain M, Lolli F, Arnaldi G, Giacchetti G, Boscaro M, Grossman AB, Korbonits M (2008) Changes in adenosine 5′-monophosphate-activated protein kinase as a mechanism of visceral obesity in Cushing’s syndrome. J Clin Endocrinol Metab 93:4969–4973CrossRefPubMed Kola B, Christ-Crain M, Lolli F, Arnaldi G, Giacchetti G, Boscaro M, Grossman AB, Korbonits M (2008) Changes in adenosine 5′-monophosphate-activated protein kinase as a mechanism of visceral obesity in Cushing’s syndrome. J Clin Endocrinol Metab 93:4969–4973CrossRefPubMed
8.
Zurück zum Zitat Geer EB, Shen W, Strohmayer E, Post KD, Freda PU (2012) Body composition and cardiovascular risk markers after remission of Cushing’s disease: a prospective study using whole-body MRI. J Clin Endocrinol Metab 97:1702–1711CrossRefPubMedCentralPubMed Geer EB, Shen W, Strohmayer E, Post KD, Freda PU (2012) Body composition and cardiovascular risk markers after remission of Cushing’s disease: a prospective study using whole-body MRI. J Clin Endocrinol Metab 97:1702–1711CrossRefPubMedCentralPubMed
9.
Zurück zum Zitat Libè R, Morpurgo PS, Cappiello V, Maffini A, Bondioni S, Locatelli M, Zavanone M, Beck-Peccoz P, Spada A (2005) Ghrelin and adiponectin in patients with Cushing’s disease before and after successful transsphenoidal surgery. Clin Endocrinol 62:30–36CrossRef Libè R, Morpurgo PS, Cappiello V, Maffini A, Bondioni S, Locatelli M, Zavanone M, Beck-Peccoz P, Spada A (2005) Ghrelin and adiponectin in patients with Cushing’s disease before and after successful transsphenoidal surgery. Clin Endocrinol 62:30–36CrossRef
10.
Zurück zum Zitat Veldman RG, Frölich M, Pincus SM, Veldhuis JD, Roelfsema F (2001) Hyperleptinemia in women with Cushing’s disease is driven by high-amplitude pulsatile, but orderly and eurhythmic, leptin secretion. Eur J Endocrinol 144:21–27CrossRefPubMed Veldman RG, Frölich M, Pincus SM, Veldhuis JD, Roelfsema F (2001) Hyperleptinemia in women with Cushing’s disease is driven by high-amplitude pulsatile, but orderly and eurhythmic, leptin secretion. Eur J Endocrinol 144:21–27CrossRefPubMed
11.
Zurück zum Zitat Krsek M, Silha JV, Jezková J, Hána V, Marek J, Weiss V, Stepán JJ, Murphy LJ (2004) Adipokine levels in Cushing’s syndrome; elevated resistin levels in female patients with Cushing’s syndrome. Clin Endocrinol 60:350–357CrossRef Krsek M, Silha JV, Jezková J, Hána V, Marek J, Weiss V, Stepán JJ, Murphy LJ (2004) Adipokine levels in Cushing’s syndrome; elevated resistin levels in female patients with Cushing’s syndrome. Clin Endocrinol 60:350–357CrossRef
12.
Zurück zum Zitat Setola E, Losa M, Lanzi R, Lucotti P, Monti LD, Castrignanò T, Galluccio E, Giovanelli M, Piatti P (2007) Increased insulin-stimulated endothelin-1 release is a distinct vascular phenotype distinguishing Cushing’s disease from metabolic syndrome. Clin Endocrinol 66:586–592 Setola E, Losa M, Lanzi R, Lucotti P, Monti LD, Castrignanò T, Galluccio E, Giovanelli M, Piatti P (2007) Increased insulin-stimulated endothelin-1 release is a distinct vascular phenotype distinguishing Cushing’s disease from metabolic syndrome. Clin Endocrinol 66:586–592
13.
Zurück zum Zitat Barahona MJ, Sucunza N, Resmini E, Fernández-Real JM, Ricart W, Moreno-Navarrete JM, Puig T, Farrerons J, Webb SM (2009) Persistent body fat mass and inflammatory marker increases after long-term cure of Cushing’s syndrome. J Clin Endocrinol Metab 94:3365–3371CrossRefPubMed Barahona MJ, Sucunza N, Resmini E, Fernández-Real JM, Ricart W, Moreno-Navarrete JM, Puig T, Farrerons J, Webb SM (2009) Persistent body fat mass and inflammatory marker increases after long-term cure of Cushing’s syndrome. J Clin Endocrinol Metab 94:3365–3371CrossRefPubMed
14.
Zurück zum Zitat Valassi E, Biller BM, Klibanski A, Misra M (2012) Adipokines and cardiovascular risk in Cushing’s syndrome. Neuroendocrinology 95:187–206CrossRefPubMed Valassi E, Biller BM, Klibanski A, Misra M (2012) Adipokines and cardiovascular risk in Cushing’s syndrome. Neuroendocrinology 95:187–206CrossRefPubMed
15.
Zurück zum Zitat Mancini T, Kola B, Mantero F, Boscaro M, Arnaldi G (2004) High cardiovascular risk in patients with Cushing’s syndrome according to 1999 WHO/ISH guidelines. Clin Endocrinol 61:768–777CrossRef Mancini T, Kola B, Mantero F, Boscaro M, Arnaldi G (2004) High cardiovascular risk in patients with Cushing’s syndrome according to 1999 WHO/ISH guidelines. Clin Endocrinol 61:768–777CrossRef
16.
Zurück zum Zitat Giordano R, Picu A, Marinazzo E, D’Angelo V, Berardelli R, Karamouzis I, Forno D, Zinnà D, Maccario M, Ghigo E, Arvat E (2011) Metabolic and cardiovascular outcomes in patients with Cushing’s syndrome of different aetiologies during active disease and 1 year after remission. Clin Endocrinol 75:354–360CrossRef Giordano R, Picu A, Marinazzo E, D’Angelo V, Berardelli R, Karamouzis I, Forno D, Zinnà D, Maccario M, Ghigo E, Arvat E (2011) Metabolic and cardiovascular outcomes in patients with Cushing’s syndrome of different aetiologies during active disease and 1 year after remission. Clin Endocrinol 75:354–360CrossRef
17.
Zurück zum Zitat Colao A, Pivonello R, Spiezia S, Faggiano A, Ferone D, Filippella M, Marzullo P, Cerbone G, Siciliani M, Lombardi G (1999) Persistence of increased cardiovascular risk in patients with Cushing’s disease after 5 years of successful cure. J Clin Endocrinol Metab 84:2664–2672PubMed Colao A, Pivonello R, Spiezia S, Faggiano A, Ferone D, Filippella M, Marzullo P, Cerbone G, Siciliani M, Lombardi G (1999) Persistence of increased cardiovascular risk in patients with Cushing’s disease after 5 years of successful cure. J Clin Endocrinol Metab 84:2664–2672PubMed
18.
Zurück zum Zitat Arnaldi G, Scandali VM, Trementino L, Cardinaletti M, Appolloni G, Boscaro M (2010) Pathophysiology of dyslipidemia in Cushing’s syndrome. Neuroendocrinology 92(suppl. 1):86–90CrossRefPubMed Arnaldi G, Scandali VM, Trementino L, Cardinaletti M, Appolloni G, Boscaro M (2010) Pathophysiology of dyslipidemia in Cushing’s syndrome. Neuroendocrinology 92(suppl. 1):86–90CrossRefPubMed
19.
Zurück zum Zitat Giordano C, Guarnotta V, Pivonello R, Amato MC, Simeoli C, Ciresi A, Cozzolino A, Colao A (2013) Is diabetes in Cushing’s syndrome only a consequence of hypercortisolism? Eur J Endocrinol 170:311–319CrossRefPubMed Giordano C, Guarnotta V, Pivonello R, Amato MC, Simeoli C, Ciresi A, Cozzolino A, Colao A (2013) Is diabetes in Cushing’s syndrome only a consequence of hypercortisolism? Eur J Endocrinol 170:311–319CrossRefPubMed
20.
Zurück zum Zitat Lambert JK, Goldberg L, Fayngold S, Kostadinov J, Post KD, Geer EB (2013) Predictors of mortality and long-term outcomes in treated Cushing’s disease: a study of 346 patients. J Clin Endocrinol Metab 98:1022–1030CrossRefPubMedCentralPubMed Lambert JK, Goldberg L, Fayngold S, Kostadinov J, Post KD, Geer EB (2013) Predictors of mortality and long-term outcomes in treated Cushing’s disease: a study of 346 patients. J Clin Endocrinol Metab 98:1022–1030CrossRefPubMedCentralPubMed
21.
Zurück zum Zitat Mazziotti G, Gazzaruso C, Giustina A (2011) Diabetes in Cushing syndrome: basic and clinical aspects. Trends Endocrinol Metab 22:499–506CrossRefPubMed Mazziotti G, Gazzaruso C, Giustina A (2011) Diabetes in Cushing syndrome: basic and clinical aspects. Trends Endocrinol Metab 22:499–506CrossRefPubMed
22.
Zurück zum Zitat Cicala MV, Mantero F (2010) Hypertension in Cushing’s syndrome: from pathogenesis to treatment. Neuroendocrinology 92(suppl. 1):44–49CrossRefPubMed Cicala MV, Mantero F (2010) Hypertension in Cushing’s syndrome: from pathogenesis to treatment. Neuroendocrinology 92(suppl. 1):44–49CrossRefPubMed
23.
Zurück zum Zitat Kirilov G, Tomova A, Dakovska L, Kumanov P, Shinkov A, Alexandrov AS (2003) Elevated plasma endothelin as an additional cardiovascular risk factor in patients with Cushing’s syndrome. Eur J Endocrinol 149:549–553CrossRefPubMed Kirilov G, Tomova A, Dakovska L, Kumanov P, Shinkov A, Alexandrov AS (2003) Elevated plasma endothelin as an additional cardiovascular risk factor in patients with Cushing’s syndrome. Eur J Endocrinol 149:549–553CrossRefPubMed
24.
Zurück zum Zitat Boscaro M, Sonino N, Scarda A, Barzon L, Fallo F, Sartori MT, Patrassi GM, Girolami A (2002) Anticoagulant prophylaxis markedly reduces thromboembolic complications in Cushing’s syndrome. J Clin Endocrinol Metab 87:3662–3666PubMed Boscaro M, Sonino N, Scarda A, Barzon L, Fallo F, Sartori MT, Patrassi GM, Girolami A (2002) Anticoagulant prophylaxis markedly reduces thromboembolic complications in Cushing’s syndrome. J Clin Endocrinol Metab 87:3662–3666PubMed
25.
Zurück zum Zitat Manetti L, Bogazzi F, Giovannetti C, Raffaelli V, Genovesi M, Pellegrini G, Ruocco L, Iannelli A, Martino E (2010) Changes in coagulation indexes and occurrence of venous thromboembolism in patients with Cushing’s syndrome: results from a prospective study before and after surgery. Eur J Endocrinol 163:783–791CrossRefPubMed Manetti L, Bogazzi F, Giovannetti C, Raffaelli V, Genovesi M, Pellegrini G, Ruocco L, Iannelli A, Martino E (2010) Changes in coagulation indexes and occurrence of venous thromboembolism in patients with Cushing’s syndrome: results from a prospective study before and after surgery. Eur J Endocrinol 163:783–791CrossRefPubMed
26.
Zurück zum Zitat Van der Pas R, Leebeek FW, Hofland LJ, de Herder WW, Feelders RA (2013) Hypercoagulability in Cushing’s syndrome: prevalence, pathogenesis and treatment. Clin Endocrinol 78:481–488CrossRef Van der Pas R, Leebeek FW, Hofland LJ, de Herder WW, Feelders RA (2013) Hypercoagulability in Cushing’s syndrome: prevalence, pathogenesis and treatment. Clin Endocrinol 78:481–488CrossRef
27.
Zurück zum Zitat Dusek T, Kastelan D, Solak M, Basic Kinda S, Aganovic I, Korsic M (2008) Polycythemia as the first manifestation of Cushing’s disease. J Endocrinol Invest 31:940CrossRefPubMed Dusek T, Kastelan D, Solak M, Basic Kinda S, Aganovic I, Korsic M (2008) Polycythemia as the first manifestation of Cushing’s disease. J Endocrinol Invest 31:940CrossRefPubMed
28.
Zurück zum Zitat Miljic P, Miljic D, Cain JW, Korbonits M, Popovic V (2012) Pathogenesis of vascular complications in Cushing’s syndrome. Hormones 11:21–30PubMed Miljic P, Miljic D, Cain JW, Korbonits M, Popovic V (2012) Pathogenesis of vascular complications in Cushing’s syndrome. Hormones 11:21–30PubMed
29.
Zurück zum Zitat Stuijver DJ, Van Zaane B, Feelders RA, Debeij J, Cannegieter SC, Hermus AR, van den Berg G, Pereira AM, de Herder WW, Wagenmakers MA, Kerstens MN, Zelissen PM, Fliers E, Schaper N, Drent ML, Dekkers OM, Gerdes VE (2011) Incidence of venous thromboembolism in patients with Cushing’s syndrome: a multicenter cohort study. J Clin Endocrinol Metab 96:3525–3532CrossRefPubMed Stuijver DJ, Van Zaane B, Feelders RA, Debeij J, Cannegieter SC, Hermus AR, van den Berg G, Pereira AM, de Herder WW, Wagenmakers MA, Kerstens MN, Zelissen PM, Fliers E, Schaper N, Drent ML, Dekkers OM, Gerdes VE (2011) Incidence of venous thromboembolism in patients with Cushing’s syndrome: a multicenter cohort study. J Clin Endocrinol Metab 96:3525–3532CrossRefPubMed
30.
Zurück zum Zitat Van Zaane B, Nur E, Squizzato A, Dekkers OM, Twickler MT, Fliers E, Gerdes VE, Büller HR, Brandjes DP (2009) Hypercoagulable state in Cushing’s syndrome: a systematic review. J Clin Endocrinol Metab 94:2743–2750CrossRefPubMed Van Zaane B, Nur E, Squizzato A, Dekkers OM, Twickler MT, Fliers E, Gerdes VE, Büller HR, Brandjes DP (2009) Hypercoagulable state in Cushing’s syndrome: a systematic review. J Clin Endocrinol Metab 94:2743–2750CrossRefPubMed
31.
Zurück zum Zitat Kastelan D, Dusek T, Kraljevic I, Aganovic I (2013) Hypercoagulable state in Cushing’s syndrome is reversible following remission. Clin Endocrinol 78:102–106CrossRef Kastelan D, Dusek T, Kraljevic I, Aganovic I (2013) Hypercoagulable state in Cushing’s syndrome is reversible following remission. Clin Endocrinol 78:102–106CrossRef
32.
Zurück zum Zitat van der Pas R, de Bruin C, Leebeek FW, de Maat MP, Rijken DC, Pereira AM, Romijn JA, Netea-Maier RT, Hermus AR, Zelissen PM, de Jong FH, van der Lely AJ, de Herder WW, Lamberts SW, Hofland LJ, Feelders RA (2012) The hypercoagulable state in Cushing’s disease is associated with increased levels of procoagulant factors and impaired fibrinolysis, but is not reversible after short-term biochemical remission induced by medical therapy. J Clin Endocrinol Metab 97:1303–1310CrossRefPubMed van der Pas R, de Bruin C, Leebeek FW, de Maat MP, Rijken DC, Pereira AM, Romijn JA, Netea-Maier RT, Hermus AR, Zelissen PM, de Jong FH, van der Lely AJ, de Herder WW, Lamberts SW, Hofland LJ, Feelders RA (2012) The hypercoagulable state in Cushing’s disease is associated with increased levels of procoagulant factors and impaired fibrinolysis, but is not reversible after short-term biochemical remission induced by medical therapy. J Clin Endocrinol Metab 97:1303–1310CrossRefPubMed
33.
Zurück zum Zitat Dekkers OM, Horváth-Puhó E, Jørgensen JO, Cannegieter SC, Ehrenstein V, Vandenbroucke JP, Pereira AM, Sørensen HT (2013) Multisystem morbidity and mortality in Cushing’s syndrome: a cohort study. J Clin Endocrinol Metab 98:2277–2284CrossRefPubMed Dekkers OM, Horváth-Puhó E, Jørgensen JO, Cannegieter SC, Ehrenstein V, Vandenbroucke JP, Pereira AM, Sørensen HT (2013) Multisystem morbidity and mortality in Cushing’s syndrome: a cohort study. J Clin Endocrinol Metab 98:2277–2284CrossRefPubMed
34.
Zurück zum Zitat Alexandraki KI, Kaltsas GA, Vouliotis AI, Papaioannou TG, Trisk L, Zilos A, Korbonits M, Besser GM, Anastasakis A, Grossman AB (2011) Specific electrocardiographic features associated with Cushing’s disease. Clin Endocrinol 74:558–564CrossRef Alexandraki KI, Kaltsas GA, Vouliotis AI, Papaioannou TG, Trisk L, Zilos A, Korbonits M, Besser GM, Anastasakis A, Grossman AB (2011) Specific electrocardiographic features associated with Cushing’s disease. Clin Endocrinol 74:558–564CrossRef
35.
Zurück zum Zitat Toja PM, Branzi G, Ciambellotti F, Radaelli P, De Martin M, Lonati LM, Scacchi M, Parati G, Cavagnini F, Pecori Giraldi F (2012) Clinical relevance of cardiac structure and function abnormalities in patients with Cushing’s syndrome before and after cure. Clin Endocrinol 76:332–338CrossRef Toja PM, Branzi G, Ciambellotti F, Radaelli P, De Martin M, Lonati LM, Scacchi M, Parati G, Cavagnini F, Pecori Giraldi F (2012) Clinical relevance of cardiac structure and function abnormalities in patients with Cushing’s syndrome before and after cure. Clin Endocrinol 76:332–338CrossRef
36.
Zurück zum Zitat Pereira AM, Delgado V, Romijn JA, Smit JW, Bax JJ, Feelders RA (2010) Cardiac dysfunction is reversed upon successful treatment of Cushing’s syndrome. Eur J Endocrinol 162:331–340CrossRefPubMed Pereira AM, Delgado V, Romijn JA, Smit JW, Bax JJ, Feelders RA (2010) Cardiac dysfunction is reversed upon successful treatment of Cushing’s syndrome. Eur J Endocrinol 162:331–340CrossRefPubMed
37.
Zurück zum Zitat Yiu KH, Marsan NA, Delgado V, Biermasz NR, Holman ER, Smit JW, Feelders RA, Bax JJ, Pereira AM (2012) Increased myocardial fibrosis and left ventricular dysfunction in Cushing’s syndrome. Eur J Endocrinol 166:27–34CrossRefPubMed Yiu KH, Marsan NA, Delgado V, Biermasz NR, Holman ER, Smit JW, Feelders RA, Bax JJ, Pereira AM (2012) Increased myocardial fibrosis and left ventricular dysfunction in Cushing’s syndrome. Eur J Endocrinol 166:27–34CrossRefPubMed
38.
39.
Zurück zum Zitat Rotondi M, Dionisio R, Fonte R, Caporotondi A, Guazzotti G, Baccheschi J, Febo O, Castellano M, Chiovato L (2011) Dilated cardiomyopathy: a possibly underestimated presentation of Cushing’s disease. Clin Endocrinol 75:864–865CrossRef Rotondi M, Dionisio R, Fonte R, Caporotondi A, Guazzotti G, Baccheschi J, Febo O, Castellano M, Chiovato L (2011) Dilated cardiomyopathy: a possibly underestimated presentation of Cushing’s disease. Clin Endocrinol 75:864–865CrossRef
40.
Zurück zum Zitat Chandran DS, Ali N, Jaryal AK, Jyotsna VP, Deepak KK (2013) Decreased autonomic modulation of heart rate and altered cardiac sympathovagal balance in patients with Cushing’s syndrome: role of endogenous hypercortisolism. Neuroendocrinology 97:309–317CrossRefPubMed Chandran DS, Ali N, Jaryal AK, Jyotsna VP, Deepak KK (2013) Decreased autonomic modulation of heart rate and altered cardiac sympathovagal balance in patients with Cushing’s syndrome: role of endogenous hypercortisolism. Neuroendocrinology 97:309–317CrossRefPubMed
41.
Zurück zum Zitat Jyotsna VP, Naseer A, Sreenivas V, Gupta N, Deepak KK (2011) Effect of Cushing’s syndrome—endogenous hypercortisolemia on cardiovascular autonomic functions. Auton Neurosci 160:99–102CrossRefPubMed Jyotsna VP, Naseer A, Sreenivas V, Gupta N, Deepak KK (2011) Effect of Cushing’s syndrome—endogenous hypercortisolemia on cardiovascular autonomic functions. Auton Neurosci 160:99–102CrossRefPubMed
42.
Zurück zum Zitat Faggiano A, Pivonello R, Spiezia S, De Martino MC, Filippella M, Di Somma C, Lombardi G, Colao A (2003) Cardiovascular risk factors and common carotid artery caliber and stiffness in patients with Cushing’s disease during active disease and 1 year after disease remission. J Clin Endocrinol Metab 88:2527–2533CrossRefPubMed Faggiano A, Pivonello R, Spiezia S, De Martino MC, Filippella M, Di Somma C, Lombardi G, Colao A (2003) Cardiovascular risk factors and common carotid artery caliber and stiffness in patients with Cushing’s disease during active disease and 1 year after disease remission. J Clin Endocrinol Metab 88:2527–2533CrossRefPubMed
43.
Zurück zum Zitat Albiger N, Testa RM, Almoto B, Ferrari M, Bilora F, Petrobelli F, Pagnan A, Mantero F, Scaroni C (2006) Patients with Cushing’s syndrome have increased intimal media thickness at different vascular levels: comparison with a population matched for similar cardiovascular risk factors. Horm Metab Res 38:405–410CrossRefPubMed Albiger N, Testa RM, Almoto B, Ferrari M, Bilora F, Petrobelli F, Pagnan A, Mantero F, Scaroni C (2006) Patients with Cushing’s syndrome have increased intimal media thickness at different vascular levels: comparison with a population matched for similar cardiovascular risk factors. Horm Metab Res 38:405–410CrossRefPubMed
44.
Zurück zum Zitat Fallo F, Famoso G, Capizzi D, Sonino N, Dassie F, Maffei P, Martini C, Paoletta A, Iliceto S, Tona F (2013) Coronary microvascular function in patients with Cushing’s syndrome. Endocrine 43:206–213CrossRefPubMed Fallo F, Famoso G, Capizzi D, Sonino N, Dassie F, Maffei P, Martini C, Paoletta A, Iliceto S, Tona F (2013) Coronary microvascular function in patients with Cushing’s syndrome. Endocrine 43:206–213CrossRefPubMed
45.
Zurück zum Zitat Rizzoni D, Porteri E, De Ciuceis C, Rodella LF, Paiardi S, Rizzardi N, Platto C, Boari GE, Pilu A, Tiberio GA, Giulini SM, Favero G, Rezzani R, Rosei CA, Bulgari G, Avanzi D, Rosei EA (2009) Hypertrophic remodeling of subcutaneous small resistance arteries in patients with Cushing’s syndrome. J Clin Endocrinol Metab 94:5010–5018CrossRefPubMed Rizzoni D, Porteri E, De Ciuceis C, Rodella LF, Paiardi S, Rizzardi N, Platto C, Boari GE, Pilu A, Tiberio GA, Giulini SM, Favero G, Rezzani R, Rosei CA, Bulgari G, Avanzi D, Rosei EA (2009) Hypertrophic remodeling of subcutaneous small resistance arteries in patients with Cushing’s syndrome. J Clin Endocrinol Metab 94:5010–5018CrossRefPubMed
46.
Zurück zum Zitat Barahona MJ, Resmini E, Viladés D, Pons-Lladó G, Leta R, Puig T, Webb SM (2013) Coronary artery disease detected by multislice computed tomography in patients after long-term cure of Cushing’s syndrome. J Clin Endocrinol Metab 98:1093–1099CrossRefPubMed Barahona MJ, Resmini E, Viladés D, Pons-Lladó G, Leta R, Puig T, Webb SM (2013) Coronary artery disease detected by multislice computed tomography in patients after long-term cure of Cushing’s syndrome. J Clin Endocrinol Metab 98:1093–1099CrossRefPubMed
47.
Zurück zum Zitat Bourdeau I, Bard C, Noël B, Leclerc I, Cordeau MP, Bélair M, Lesage J, Lafontaine L, Lacroix A (2002) Loss of brain volume in endogenous Cushing’s syndrome and its reversibility after correction of hypercortisolism. J Clin Endocrinol Metab 87:1949–1954PubMed Bourdeau I, Bard C, Noël B, Leclerc I, Cordeau MP, Bélair M, Lesage J, Lafontaine L, Lacroix A (2002) Loss of brain volume in endogenous Cushing’s syndrome and its reversibility after correction of hypercortisolism. J Clin Endocrinol Metab 87:1949–1954PubMed
48.
Zurück zum Zitat Starkman MN, Gebarski SS, Berent S, Schteingart DE (1992) Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing’s syndrome. Biol Psychiatry 32:756–765CrossRefPubMed Starkman MN, Gebarski SS, Berent S, Schteingart DE (1992) Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing’s syndrome. Biol Psychiatry 32:756–765CrossRefPubMed
49.
Zurück zum Zitat Dimopoulou C, Ising M, Pfister H, Schopohl J, Stalla GK, Sievers C (2013) Increased prevalence of anxiety-associated personality traits in patients with Cushing’s disease: a cross-sectional study. Neuroendocrinology 97:139–145CrossRefPubMed Dimopoulou C, Ising M, Pfister H, Schopohl J, Stalla GK, Sievers C (2013) Increased prevalence of anxiety-associated personality traits in patients with Cushing’s disease: a cross-sectional study. Neuroendocrinology 97:139–145CrossRefPubMed
50.
Zurück zum Zitat Langenecker SA, Weisenbach SL, Giordani B, Briceño EM, Guidotti Breting LM, Schallmo MP, Leon HM, Noll DC, Zubieta JK, Schteingart DE, Starkman MN (2012) Impact of chronic hypercortisolemia on affective processing. Neuropharmacology 62:217–225CrossRefPubMedCentralPubMed Langenecker SA, Weisenbach SL, Giordani B, Briceño EM, Guidotti Breting LM, Schallmo MP, Leon HM, Noll DC, Zubieta JK, Schteingart DE, Starkman MN (2012) Impact of chronic hypercortisolemia on affective processing. Neuropharmacology 62:217–225CrossRefPubMedCentralPubMed
51.
Zurück zum Zitat Toffanin T, Nifosì F, Follador H, Passamani A, Zonta F, Ferri G, Scanarini M, Amistà P, Pigato G, Scaroni C, Mantero F, Carollo C, Perini GI (2011) Volumetric MRI analysis of hippocampal subregions in Cushing’s disease: a model for glucocorticoid neural modulation. Eur Psychiatry 26:64–67CrossRefPubMed Toffanin T, Nifosì F, Follador H, Passamani A, Zonta F, Ferri G, Scanarini M, Amistà P, Pigato G, Scaroni C, Mantero F, Carollo C, Perini GI (2011) Volumetric MRI analysis of hippocampal subregions in Cushing’s disease: a model for glucocorticoid neural modulation. Eur Psychiatry 26:64–67CrossRefPubMed
52.
Zurück zum Zitat Starkman MN, Giordani B, Gebarski SS, Berent S, Schork MA, Schteingart DE (1999) Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing’s disease. Biol Psychiatry 46:1595–1602CrossRefPubMed Starkman MN, Giordani B, Gebarski SS, Berent S, Schork MA, Schteingart DE (1999) Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing’s disease. Biol Psychiatry 46:1595–1602CrossRefPubMed
53.
Zurück zum Zitat Starkman MN, Giordani B, Gebarski SS, Schteingart DE (2007) Improvement in mood and ideation associated with increase in right caudate volume. J Affect Disord 101:139–147CrossRefPubMed Starkman MN, Giordani B, Gebarski SS, Schteingart DE (2007) Improvement in mood and ideation associated with increase in right caudate volume. J Affect Disord 101:139–147CrossRefPubMed
54.
Zurück zum Zitat Starkman MN, Giordani B, Gebarski SS, Schteingart DE (2003) Improvement in learning associated with increase in hippocampal formation volume. Biol Psychiatry 53:233–238CrossRefPubMed Starkman MN, Giordani B, Gebarski SS, Schteingart DE (2003) Improvement in learning associated with increase in hippocampal formation volume. Biol Psychiatry 53:233–238CrossRefPubMed
55.
Zurück zum Zitat Hook JN, Giordani B, Schteingart DE, Guire K, Giles J, Ryan K, Gebarski SS, Langenecker SA, Starkman MN (2007) Patterns of cognitive change over time and relationship to age following successful treatment of Cushing’s disease. J Int Neuropsychol Soc 13:21–29CrossRefPubMed Hook JN, Giordani B, Schteingart DE, Guire K, Giles J, Ryan K, Gebarski SS, Langenecker SA, Starkman MN (2007) Patterns of cognitive change over time and relationship to age following successful treatment of Cushing’s disease. J Int Neuropsychol Soc 13:21–29CrossRefPubMed
56.
Zurück zum Zitat Resmini E, Santos A, Gómez-Anson B, Vives Y, Pires P, Crespo I, Portella MJ, de Juan-Delago M, Barahona MJ, Webb SM (2012) Verbal and visual memory performance and hippocampal volumes, measured by 3-Tesla magnetic resonance imaging, in patients with Cushing’s syndrome. J Clin Endocrinol Metab 97:663–671CrossRefPubMed Resmini E, Santos A, Gómez-Anson B, Vives Y, Pires P, Crespo I, Portella MJ, de Juan-Delago M, Barahona MJ, Webb SM (2012) Verbal and visual memory performance and hippocampal volumes, measured by 3-Tesla magnetic resonance imaging, in patients with Cushing’s syndrome. J Clin Endocrinol Metab 97:663–671CrossRefPubMed
57.
Zurück zum Zitat Resmini E, Santos A, Gómez-Anson B, López-Mourelo O, Pires P, Vives-Gilabert Y, Crespo I, Portella MJ, de Juan-Delago M, Webb SM (2013) Hippocampal dysfunction in cured Cushing’s syndrome patients, detected by (1) H-MR-spectroscopy. Clin Endocrinol 79:700–707 Resmini E, Santos A, Gómez-Anson B, López-Mourelo O, Pires P, Vives-Gilabert Y, Crespo I, Portella MJ, de Juan-Delago M, Webb SM (2013) Hippocampal dysfunction in cured Cushing’s syndrome patients, detected by (1) H-MR-spectroscopy. Clin Endocrinol 79:700–707
58.
Zurück zum Zitat Andela CD, van der Werff SJ, Pannekoek JN, van den Berg SM, Meijer OC, van Buchem MA, Rombouts SA, van der Mast RC, Romijn JA, Tiemensma J, Biermasz NR, van der Wee NJ, Pereira AM (2013) Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with long-term remission of Cushing’s disease: a case-control study. Eur J Endocrinol 169:811–819CrossRefPubMed Andela CD, van der Werff SJ, Pannekoek JN, van den Berg SM, Meijer OC, van Buchem MA, Rombouts SA, van der Mast RC, Romijn JA, Tiemensma J, Biermasz NR, van der Wee NJ, Pereira AM (2013) Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with long-term remission of Cushing’s disease: a case-control study. Eur J Endocrinol 169:811–819CrossRefPubMed
59.
Zurück zum Zitat Tiemensma J, Biermasz NR, Middelkoop HA, van der Mast RC, Romijn JA, Pereira AM (2010) Increased prevalence of psychopathology and maladaptive personality traits after long-term cure of Cushing’s disease. J Clin Endocrinol Metab 95:E129–E141CrossRefPubMed Tiemensma J, Biermasz NR, Middelkoop HA, van der Mast RC, Romijn JA, Pereira AM (2010) Increased prevalence of psychopathology and maladaptive personality traits after long-term cure of Cushing’s disease. J Clin Endocrinol Metab 95:E129–E141CrossRefPubMed
60.
Zurück zum Zitat Lado-Abeal J, Rodriguez-Arnao J, Newell-Price JD, Perry LA, Grossman AB, Besser GM, Trainer PJ (1998) Menstrual abnormalities in women with Cushing’s disease are correlated with hypercortisolemia rather than raised circulating androgen levels. J Clin Endocrinol Metab 83:3083–3088PubMed Lado-Abeal J, Rodriguez-Arnao J, Newell-Price JD, Perry LA, Grossman AB, Besser GM, Trainer PJ (1998) Menstrual abnormalities in women with Cushing’s disease are correlated with hypercortisolemia rather than raised circulating androgen levels. J Clin Endocrinol Metab 83:3083–3088PubMed
61.
Zurück zum Zitat Lindsay JR, Nansel T, Baid S, Gumowski J, Nieman LK (2006) Long-term impaired quality of life in Cushing’s syndrome despite initial improvement after surgical remission. J Clin Endocrinol Metab 91:447–453CrossRefPubMed Lindsay JR, Nansel T, Baid S, Gumowski J, Nieman LK (2006) Long-term impaired quality of life in Cushing’s syndrome despite initial improvement after surgical remission. J Clin Endocrinol Metab 91:447–453CrossRefPubMed
62.
63.
Zurück zum Zitat Shibli-Rahhal A, Van Beek M, Schlechte JA (2006) Cushing’s syndrome. Clin Dermatol 24:260–265CrossRefPubMed Shibli-Rahhal A, Van Beek M, Schlechte JA (2006) Cushing’s syndrome. Clin Dermatol 24:260–265CrossRefPubMed
64.
Zurück zum Zitat Davidovici BB, Orion E, Wolf R (2008) Cutaneous manifestations of pituitary gland diseases. Clin Dermatol 26:288–295CrossRefPubMed Davidovici BB, Orion E, Wolf R (2008) Cutaneous manifestations of pituitary gland diseases. Clin Dermatol 26:288–295CrossRefPubMed
65.
Zurück zum Zitat Minetto MA, Lanfranco F, Botter A, Motta G, Mengozzi G, Giordano R, Picu A, Ghigo E, Arvat E (2011) Do muscle fiber conduction slowing and decreased levels of circulating muscle proteins represent sensitive markers of steroid myopathy? A pilot study in Cushing’s disease. Eur J Endocrinol 164:985–993CrossRefPubMed Minetto MA, Lanfranco F, Botter A, Motta G, Mengozzi G, Giordano R, Picu A, Ghigo E, Arvat E (2011) Do muscle fiber conduction slowing and decreased levels of circulating muscle proteins represent sensitive markers of steroid myopathy? A pilot study in Cushing’s disease. Eur J Endocrinol 164:985–993CrossRefPubMed
66.
Zurück zum Zitat Belaya ZE, Rozhinskaya LY, Melnichenko GA, Solodovnikov AG, Dragunova NV, Iljin AV, Dzeranova LK, Dedov II (2013) Serum extracellular secreted antagonists of the canonical Wnt/β-catenin signaling pathway in patients with Cushing’s syndrome. Osteoporos Int 24:2191–2199CrossRefPubMed Belaya ZE, Rozhinskaya LY, Melnichenko GA, Solodovnikov AG, Dragunova NV, Iljin AV, Dzeranova LK, Dedov II (2013) Serum extracellular secreted antagonists of the canonical Wnt/β-catenin signaling pathway in patients with Cushing’s syndrome. Osteoporos Int 24:2191–2199CrossRefPubMed
67.
Zurück zum Zitat Lekva T, Ueland T, Bøyum H, Evang JA, Godang K, Bollerslev J (2012) TXNIP is highly regulated in bone biopsies from patients with endogenous Cushing’s syndrome and related tobone turnover. Eur J Endocrinol 166:1039–1048CrossRefPubMed Lekva T, Ueland T, Bøyum H, Evang JA, Godang K, Bollerslev J (2012) TXNIP is highly regulated in bone biopsies from patients with endogenous Cushing’s syndrome and related tobone turnover. Eur J Endocrinol 166:1039–1048CrossRefPubMed
68.
Zurück zum Zitat Barahona MJ, Sucunza N, Resmini E, Fernández-Real JM, Ricart W, Moreno-Navarrete JM, Puig T, Wägner AM, Rodriguez-Espinosa J, Farrerons J, Webb SM (2009) Deleterious effects of glucocorticoid replacement on bone in women after long-term remission of Cushing’s syndrome. J Bone Miner Res 24:1841–1846CrossRefPubMed Barahona MJ, Sucunza N, Resmini E, Fernández-Real JM, Ricart W, Moreno-Navarrete JM, Puig T, Wägner AM, Rodriguez-Espinosa J, Farrerons J, Webb SM (2009) Deleterious effects of glucocorticoid replacement on bone in women after long-term remission of Cushing’s syndrome. J Bone Miner Res 24:1841–1846CrossRefPubMed
69.
Zurück zum Zitat Hermus AR, Smals AG, Swinkels LM, Huysmans DA, Pieters GF, Sweep CF, Corstens FH, Kloppenborg PW (1995) Bone mineral density and bone turnover before and after surgical cure of Cushing’s syndrome. J Clin Endocrinol Metab 80:2859–2865PubMed Hermus AR, Smals AG, Swinkels LM, Huysmans DA, Pieters GF, Sweep CF, Corstens FH, Kloppenborg PW (1995) Bone mineral density and bone turnover before and after surgical cure of Cushing’s syndrome. J Clin Endocrinol Metab 80:2859–2865PubMed
70.
Zurück zum Zitat Kristo C, Jemtland R, Ueland T, Godang K, Bollerslev J (2006) Restoration of the coupling process and normalization of bone mass following successful treatment of endogenous Cushing’s syndrome: a prospective, long-term study. Eur J Endocrinol 154:109–118CrossRefPubMed Kristo C, Jemtland R, Ueland T, Godang K, Bollerslev J (2006) Restoration of the coupling process and normalization of bone mass following successful treatment of endogenous Cushing’s syndrome: a prospective, long-term study. Eur J Endocrinol 154:109–118CrossRefPubMed
71.
Zurück zum Zitat Randazzo ME, Grossrubatscher E, Ciaramella PD, Vanzulli A, Loli P (2012) Spontaneous recovery of bone mass after cure of endogenous hypercortisolism. Pituitary 15:193–201CrossRefPubMed Randazzo ME, Grossrubatscher E, Ciaramella PD, Vanzulli A, Loli P (2012) Spontaneous recovery of bone mass after cure of endogenous hypercortisolism. Pituitary 15:193–201CrossRefPubMed
72.
Zurück zum Zitat Koch CA, Tsigos C, Patronas NJ, Papanicolaou DA (1999) Cushing’s disease presenting with avascular necrosis of the hip: an orthopedic emergency. J Clin Endocrinol Metab 84:3010–3012PubMed Koch CA, Tsigos C, Patronas NJ, Papanicolaou DA (1999) Cushing’s disease presenting with avascular necrosis of the hip: an orthopedic emergency. J Clin Endocrinol Metab 84:3010–3012PubMed
73.
Zurück zum Zitat Giovansili I, Belange G, Affortit A (2013) Cushing disease revealed by bilateral atypical central serous chorioretinopathy: case report. Endocr Pract 19:e129–e133CrossRefPubMed Giovansili I, Belange G, Affortit A (2013) Cushing disease revealed by bilateral atypical central serous chorioretinopathy: case report. Endocr Pract 19:e129–e133CrossRefPubMed
75.
Zurück zum Zitat Wagenmakers MA, Netea-Maier RT, Prins JB, Dekkers T, den Heijer M, Hermus AR (2012) Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism? Eur J Endocrinol 167:687–695CrossRefPubMed Wagenmakers MA, Netea-Maier RT, Prins JB, Dekkers T, den Heijer M, Hermus AR (2012) Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism? Eur J Endocrinol 167:687–695CrossRefPubMed
76.
Zurück zum Zitat Alcalar N, Ozkan S, Kadioglu P, Celik O, Cagatay P, Kucukyuruk B, Gazioglu N (2013) Evaluation of depression, quality of life and body image in patients with Cushing’s disease. Pituitary 16:333–340CrossRefPubMed Alcalar N, Ozkan S, Kadioglu P, Celik O, Cagatay P, Kucukyuruk B, Gazioglu N (2013) Evaluation of depression, quality of life and body image in patients with Cushing’s disease. Pituitary 16:333–340CrossRefPubMed
77.
Zurück zum Zitat Tiemensma J, Kaptein AA, Pereira AM, Smit JW, Romijn JA, Biermasz NR (2011) Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing’s syndrome. Eur J Endocrinol 165:527–535CrossRefPubMed Tiemensma J, Kaptein AA, Pereira AM, Smit JW, Romijn JA, Biermasz NR (2011) Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing’s syndrome. Eur J Endocrinol 165:527–535CrossRefPubMed
78.
Zurück zum Zitat Da Mota F, Murray C, Ezzat S (2011) Overt immune dysfunction after Cushing’s syndrome remission: a consecutive case series and review of the literature. J Clin Endocrinol Metab 96:E1670–E1674CrossRefPubMed Da Mota F, Murray C, Ezzat S (2011) Overt immune dysfunction after Cushing’s syndrome remission: a consecutive case series and review of the literature. J Clin Endocrinol Metab 96:E1670–E1674CrossRefPubMed
79.
Zurück zum Zitat Russo L, Vitti P, Pinchera A, Marinò M (2010) Exacerbation of autoimmune thyroiditis following bilateral adrenalectomy for Cushing’s syndrome. Thyroid 20:669–670CrossRefPubMed Russo L, Vitti P, Pinchera A, Marinò M (2010) Exacerbation of autoimmune thyroiditis following bilateral adrenalectomy for Cushing’s syndrome. Thyroid 20:669–670CrossRefPubMed
80.
Zurück zum Zitat Peixoto I, Maquine G, Francesconi VA, Francesconi F (2010) Dermatophytosis caused by Tricophyton rubrum as an opportunistic infection in patients with Cushing disease. An Bras Dermatol 85:888–890CrossRefPubMed Peixoto I, Maquine G, Francesconi VA, Francesconi F (2010) Dermatophytosis caused by Tricophyton rubrum as an opportunistic infection in patients with Cushing disease. An Bras Dermatol 85:888–890CrossRefPubMed
81.
Zurück zum Zitat Scheffel RS, Dora JM, Weinert LS, Aquino V, Maia AL, Canani LH, Goldani LZ (2010) Invasive fungal infections in endogenous Cushing’s syndrome. Infect Dis Rep 2:e4CrossRefPubMedCentralPubMed Scheffel RS, Dora JM, Weinert LS, Aquino V, Maia AL, Canani LH, Goldani LZ (2010) Invasive fungal infections in endogenous Cushing’s syndrome. Infect Dis Rep 2:e4CrossRefPubMedCentralPubMed
82.
Zurück zum Zitat Kronfol Z, Starkman M, Schteingart DE, Singh V, Zhang Q, Hill E (1996) Immune regulation in Cushing’s syndrome: relationship to hypothalamic-pituitary-adrenal axis hormones. Psychoneuroendocrinology 21:599–608CrossRefPubMed Kronfol Z, Starkman M, Schteingart DE, Singh V, Zhang Q, Hill E (1996) Immune regulation in Cushing’s syndrome: relationship to hypothalamic-pituitary-adrenal axis hormones. Psychoneuroendocrinology 21:599–608CrossRefPubMed
83.
Zurück zum Zitat Faggiano A, Pivonello R, Melis D, Filippella M, Di Somma C, Petretta M, Lombardi G, Colao A (2003) Nephrolithiasis in Cushing’s disease: prevalence, etiopathogenesis, and modification after disease cure. J Clin Endocrinol Metab 88:2076–2080CrossRefPubMed Faggiano A, Pivonello R, Melis D, Filippella M, Di Somma C, Petretta M, Lombardi G, Colao A (2003) Nephrolithiasis in Cushing’s disease: prevalence, etiopathogenesis, and modification after disease cure. J Clin Endocrinol Metab 88:2076–2080CrossRefPubMed
84.
Zurück zum Zitat Storr HL, Alexandraki KI, Martin L, Isidori AM, Kaltsas GA, Monson JP, Besser GM, Matson M, Evanson J, Afshar F, Sabin I, Savage MO, Grossman AB (2011) Comparisons in the epidemiology, diagnostic features and cure rate by transsphenoidal surgery between paediatric and adult-onset Cushing’s disease. Eur J Endocrinol 164:667–674CrossRefPubMed Storr HL, Alexandraki KI, Martin L, Isidori AM, Kaltsas GA, Monson JP, Besser GM, Matson M, Evanson J, Afshar F, Sabin I, Savage MO, Grossman AB (2011) Comparisons in the epidemiology, diagnostic features and cure rate by transsphenoidal surgery between paediatric and adult-onset Cushing’s disease. Eur J Endocrinol 164:667–674CrossRefPubMed
85.
Zurück zum Zitat Dupuis CC, Storr HL, Perry LA, Ho JT, Ahmed L, Ong KK, Dunger DB, Monson JP, Grossman AB, Besser GM, Savage MO (2007) Abnormal puberty in paediatric Cushing’s disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Clin Endocrinol 66:838–843CrossRef Dupuis CC, Storr HL, Perry LA, Ho JT, Ahmed L, Ong KK, Dunger DB, Monson JP, Grossman AB, Besser GM, Savage MO (2007) Abnormal puberty in paediatric Cushing’s disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Clin Endocrinol 66:838–843CrossRef
Metadaten
Titel
Clinical and biochemical manifestations of Cushing’s
verfasst von
Georgia Ntali
Ashley Grossman
Niki Karavitaki
Publikationsdatum
01.04.2015
Verlag
Springer US
Erschienen in
Pituitary / Ausgabe 2/2015
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-014-0631-4

Weitere Artikel der Ausgabe 2/2015

Pituitary 2/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.