Document Detail


Cyclical Cushing's syndrome: an update.
MedLine Citation:
PMID:  17940459     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: This article reviews the features of cyclical hypercortisolism. This syndrome was once considered to be very rare but is now being increasingly recognized. RECENT FINDINGS: Either true cycles or the variant of episodic and fluctuating levels of hypercortisolism can lead to considerable clinical dilemmas, which are discussed. The review details possible pathophysiological mechanisms and the effects of centrally acting drugs. SUMMARY: Cyclical Cushing's syndrome is a pattern of hypercortisolism in which the biochemistry of cortisol production fluctuates rhythmically. This syndrome is often associated with fluctuating symptoms and signs. This type of case was initially thought to be rare. It has, however, recently been recognized as occurring much more frequently. The phenomenon is important because it can, if not recognized, lead to errors in diagnosis and differential diagnosis of the syndrome and in assessment of therapeutic outcomes. All of these can have very serious clinical consequences. Clinical researchers, including ourselves, have developed criteria, protocols and dynamic biochemical tools to detect cycling in patients with hypercortisolism. Unfortunately, the mechanisms causing the abnormal pathophysiology have not been well elucidated but some recent insights have been gained. The review discusses strategies for diagnosing and managing this important subgroup of patients with hypercortisolism.
Authors:
Karen R Mullan; A Brew Atkinson; Brian Sheridan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in endocrinology, diabetes, and obesity     Volume:  14     ISSN:  1752-2978     ISO Abbreviation:  -     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-10-17     Completed Date:  2008-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308636     Medline TA:  Curr Opin Endocrinol Diabetes Obes     Country:  England    
Other Details:
Languages:  eng     Pagination:  317-22     Citation Subset:  IM    
Affiliation:
Regional Centre for Endocrinology andDiabetes, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
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MeSH Terms
Descriptor/Qualifier:
Cushing Syndrome / diagnosis*,  drug therapy*,  etiology
Humans
Hydrocortisone / biosynthesis
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone

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