Assessment of the hypothalamic-pituitary-adrenal axis in Cushing's disease diagnosis and remission

被引：5

作者：

Costenaro, Fabiola ^{[2
]}

Rodrigues, Ticiana C. ^{[1
,2
]}

Rollin, Guilherme A. F. ^{[2
]}

Czepielewski, Mauro A. ^{[1
,2
]}

机构：

[1] Hosp Clin Porto Alegre, Serv Endocrinol, BR-90035003 Porto Alegre, RS, Brazil

[2] Univ Fed Rio Grande do Sul, Programa Posgrad Ciencias Med Endocrinol, Porto Alegre, RS, Brazil

来源：

ARQUIVOS BRASILEIROS DE ENDOCRINOLOGIA E METABOLOGIA | 2012年 / 56卷 / 03期

关键词：

Cushing's disease; serum cortisol; remission; pituitary surgery; LONG-TERM REMISSION; DEXAMETHASONE-SUPPRESSION TEST; HORMONE-STIMULATION TEST; TRANSSPHENOIDAL SURGERY; DIFFERENTIAL-DIAGNOSIS; DESMOPRESSIN TEST; SERUM CORTISOL; POSTOPERATIVE CORTISOL; FOLLOW-UP; CURE;

D O I：

10.1590/S0004-27302012000300002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Cushing's disease (CD) remains a medical challenge, with many questions still unanswered. Successful treatment of CD patients is closely related to correct approach to syndromic and etiological diagnosis, besides the experience and talent of the neurosurgeon. Pituitary transsphenoidal adenomectomy is the treatment of choice for DC. Assessment of remission after surgery and recurrence in the long term is an even greater challenge. In this regard, special attention should be paid to the role of postoperative serum cortisol as a marker of CD remission. Additionally, the postoperative use of exogenous glucocorticoids only in cases of adrenal insufficiency has been suggested by some authors as an essential practice to enable the use of serum cortisol in this scenario. In this article, we review the forms of evaluation of DC activity, and markers of remission and relapse of CD after transsphenoidal surgery. Arq Bras Endocrinol Metab. 2012;56(3):159-67

引用

页码：159 / 167

页数：9

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