Aspetti clinici e preclinici della sindrome di Cushing surrenalica.

Translated title of the contribution: Clinical and preclinical aspects of adrenal Cushing syndrome

B. Ambrosi, T. Re, E. Passini, S. Peverelli, A. Sartorio, P. Colombo

Research output: Contribution to journalArticle

Abstract

Cushing's syndrome of adrenal origin encompasses different entities: besides the occurrence of adenoma and carcinoma, a not homogeneous group includes the ACTH-independent macro- or micronodular bilateral hyperplasia and the familial pigmented nodular hyperplasia (Carney's syndrome). Moreover, isolated cases of immunological origin and food-dependence have recently described. On clinical grounds no major characteristics may help to identify the adrenal origin of Cushing's syndrome, except for few situations as carcinoma or nodular dysplasia. Laboratory investigations of patients with adrenocortical tumor are based on ACTH and cortisol determinations in basal conditions and in response to high dose dexamethasone and CRH tests. However, isolated diagnostic problems may occur, as the presence of a black adrenocortical adenoma or the uncommon persistence of a circadian rhythmicity of glucocorticoid secretion. The evaluation of new markers of bone turnover (BGP, ICTP) and of collagen turnover (PIIINP) confirms the existence of corticosteroid-induced bone and collagen damages and may also be a useful prognostic index after treatment. Although up to now food-dependent Cushing's syndrome appears to be very rare, the adrenocortical sensitivity to GIP has been investigated in patients with either pituitary Cushing's disease, or clinically silent adrenal masses. No evidence of GIP-dependent cortisol secretion during the peptide infusion or after endogenous stimulation by OGTT was observed in any case. Since the wide availability of sensitive and noninvasive imaging techniques (CT and NMR), in recent years the finding of incidentalomas has become fairly common. In patients with incidentaloma abnormalities of the endocrine function are frequently encountered, and the "preclinical" Cushing's syndrome is increasingly recognized.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageItalian
Pages (from-to)39-47
Number of pages9
JournalMinerva Endocrinologica
Volume20
Issue number1
Publication statusPublished - Mar 1995

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Cushing Syndrome
Adrenocorticotropic Hormone
Hyperplasia
Hydrocortisone
Collagen
Carney Complex
Adrenocortical Adenoma
Carcinoma
Food
Pituitary ACTH Hypersecretion
Bone Remodeling
Periodicity
Glucose Tolerance Test
Adenoma
Dexamethasone
Glucocorticoids
Adrenal Cortex Hormones
Bone and Bones
Peptides
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

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Aspetti clinici e preclinici della sindrome di Cushing surrenalica. / Ambrosi, B.; Re, T.; Passini, E.; Peverelli, S.; Sartorio, A.; Colombo, P.

In: Minerva Endocrinologica, Vol. 20, No. 1, 03.1995, p. 39-47.

Research output: Contribution to journalArticle

Ambrosi, B, Re, T, Passini, E, Peverelli, S, Sartorio, A & Colombo, P 1995, 'Aspetti clinici e preclinici della sindrome di Cushing surrenalica.', Minerva Endocrinologica, vol. 20, no. 1, pp. 39-47.
Ambrosi, B. ; Re, T. ; Passini, E. ; Peverelli, S. ; Sartorio, A. ; Colombo, P. / Aspetti clinici e preclinici della sindrome di Cushing surrenalica. In: Minerva Endocrinologica. 1995 ; Vol. 20, No. 1. pp. 39-47.
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