Document Detail


Successful treatment with sodium valproate of a patient with Cushing's disease and gross enlargement of the pituitary.
MedLine Citation:
PMID:  6097074     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transfrontal hypophysectomy was performed in a patient with Cushing's disease and gross enlargement of the pituitary. Despite some reduction of cortisol production active Cushing's syndrome remained due to the presence of a tumour remnant. Medical treatment with the GABA-transaminase inhibitor sodium valproate induced hypocorticism necessitating corticosteroid substitution therapy. Nine months after sodium valproate withdrawal hypercorticism was documented. Re-institution of sodium valproate treatment induced hypocorticism again. As sodium valproate is known to induce a decrease of plasma ACTH in Nelson's syndrome, it is proposed that large tumours present at the time of diagnosis and those appearing after adrenalectomy may represent the spectrum of a single disorder. A prospective trial to study the effects of sodium valproate and other neurotransmitter modulating agents on the size and endocrine function of ACTH secreting macroadenomas is urgently needed.
Authors:
H P Koppeschaar; R J Croughs; J W van't Verlaat; M J Hendriks; C J Arts; J H Thijssen; F Schwarz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta endocrinologica     Volume:  107     ISSN:  0001-5598     ISO Abbreviation:  Acta Endocrinol.     Publication Date:  1984 Dec 
Date Detail:
Created Date:  1985-02-14     Completed Date:  1985-02-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370312     Medline TA:  Acta Endocrinol (Copenh)     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  471-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
17-Hydroxycorticosteroids / urine
Adenoma / blood,  complications*
Adrenocorticotropic Hormone / blood
Cushing Syndrome / blood,  complications,  drug therapy*
Female
Humans
Hydrocortisone / blood
Middle Aged
Pituitary Neoplasms / blood,  complications*
Valproic Acid / therapeutic use*
Chemical
Reg. No./Substance:
0/17-Hydroxycorticosteroids; 50-23-7/Hydrocortisone; 9002-60-2/Adrenocorticotropic Hormone; 99-66-1/Valproic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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