Cyclic Cushing's syndrome : an overview

Cyclic Cushing's syndrome (CS) is a disorder in which glucocorticoid levels are alternately normal and high, the latter occurring in episodes that can last from a few days to several months. It is more common in children than in adults. Cyclic CS may be either of the two different forms of CS (ACTH-dependent or -independent CS). Clinically, it may present with one or many symptoms, depending on the duration of disease activity and the timing of the fluctuations. A serotoninergic influence, cyclic changes in central dopaminergic tone, spontaneous episodic hemorrhage in the tumor, and the action of inflammatory cytokines with antitumor properties are some of the mechanisms suggested to explain the physiopathology of this phenomenon but the exact mechanism remains to be clarified. The cyclic pattern of hypercortisolism can delay the final diagnosis of CS and make it difficult to interpret the results of dynamic tests. Patients may have paradoxical responses to dexamethasone that can reflect increasing or decreasing levels of endogenous activity. Hormone assessments have to be repeated periodically when a diagnosis of CS is suspected. The cyclic pattern can also interfere with medical treatment because patients may show unexpected clinical and biochemical signs of hypocortisolism when cortisol secretion cyclically returns to normal, so an accurate follow-up is mandatory in these patients.

Medienart:

Artikel

Erscheinungsjahr:

2007

Erschienen:

2007

Enthalten in:

Zur Gesamtaufnahme - volume:51

Enthalten in:

Arquivos brasileiros de endocrinologia e metabologia - 51(2007), 8 vom: 07. Nov., Seite 1253-60

Sprache:

Englisch

Beteiligte Personen:

Albiger, Nora Maria Elvira [VerfasserIn]
Scaroni, Carla M [VerfasserIn]
Mantero, Franco [VerfasserIn]

Themen:

9002-60-2
Adrenocorticotropic Hormone
Hydrocortisone
Journal Article
Review
WI4X0X7BPJ

Anmerkungen:

Date Completed 01.12.2008

Date Revised 08.04.2022

published: Print

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM176997261