Cushing's disease: pathobiology, diagnosis, and management

被引：135

作者：

Lonser, Russell R. ^{[1
]}

Nieman, Lynnette ^{[2
]}

Oldfield, Edward H. ^{[3
]}

机构：

[1] Ohio State Univ, Dept Neurol Surg, Wexner Med Ctr, 410 W 10th Ave,Doan Hall N1047, Columbus, OH 43210 USA

[2] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Program Reprod & Adult Endocrinol, NIH, Bethesda, MD USA

[3] Univ Virginia Hlth Syst, Dept Neurol Surg, Charlottesville, VA USA

来源：

JOURNAL OF NEUROSURGERY | 2017年 / 126卷 / 02期

关键词：

Cushing's disease; diagnosis; surgery; treatment; oncology; CORTICOTROPIN-RELEASING-HORMONE; LONG-TERM REMISSION; SINGLE-CENTER EXPERIENCE; GLUCOCORTICOID-RECEPTOR ANTAGONIST; CLINICAL-PRACTICE GUIDELINE; GENDER-RELATED DIFFERENCES; TRANSSPHENOIDAL SURGERY; DIFFERENTIAL-DIAGNOSIS; PITUITARY-ADENOMAS; NEUROLOGIC COMPLICATIONS;

D O I：

10.3171/2016.1.JNS152119

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Cushing's disease (CD) is the result of excess secretion of adrenocorticotropic hormone (ACTH) by a benign monoclonal pituitary adenoma. The excessive secretion of ACTH stimulates secretion of cortisol by the adrenal glands, resulting in supraphysiological levels of circulating cortisol. The pathophysiological levels of cortisol are associated with hypertension, diabetes, obesity, and early death. Successful resection of the CD-associated ACTH-secreting pituitary adenoma is the treatment of choice and results in immediate biochemical remission with preservation of pituitary function. Accurate and early identification of CD is critical for effective surgical management and optimal prognosis. The authors review the current pathophysiological principles, diagnostic methods, and management of CD.

引用

页码：404 / 417

页数：14

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