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Cushing's syndrome – Disease monitoring: Recurrence, surveillance with biomarkers or imaging studies

Artikel i vetenskaplig tidskrift
Författare Oskar Ragnarsson
Publicerad i Best Practice and Research: Clinical Endocrinology and Metabolism
Volym 34
Nummer/häfte 2
ISSN 1521-690X
Publiceringsår 2020
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Språk en
Länkar dx.doi.org/10.1016/j.beem.2020.1013...
Ämnesord Cushing's disease, Cushing's syndrome, Nelson's syndrome, recurrence, relapse, surveillance
Ämneskategorier Endokrinologi och diabetes

Sammanfattning

Pituitary surgery is the first-line treatment for patients with Cushing's disease. For patients who are not considered candidates for pituitary surgery, pituitary radiation and bilateral adrenalectomy are further treatment alternatives. Not all patients are cured with pituitary surgery, and a substantial number of patients develop recurrence, sometimes many years after an apparently successful treatment. The same applies to patients treated with radiotherapy. Far from all patients are cured, and in many cases the disease recurs. Bilateral adrenalectomy, although always curative, causes chronic adrenal insufficiency and the remaining pituitary tumour can continue to grow and cause symptoms due to pressure on adjacent tissues, a phenomenon called Nelson's syndrome. In this paper the rate of recurrence of hypercortisolism, as well as the rate of development of Nelson's syndrome, following treatment of patients with Cushing's syndrome, will be reviewed. The aim of the paper is also to summarize clinical and biochemical factors that are associated with recurrence of hypercortisolism and how the patients should be monitored following treatment. © 2020 Elsevier Ltd

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