G. Akcay et al., RELATIONSHIP BETWEEN ADRENAL-CORTEX PATHOLOGY IN CUSHINGS-SYNDROME AND ITS RESPONSE TO THE DEXAMETHASONE SUPPRESSION TEST, Journal of international medical research, 24(3), 1996, pp. 278-283
Citations number
9
Categorie Soggetti
Pharmacology & Pharmacy","Medicine, Research & Experimental
Cushing's syndrome is a severely disabling condition which can cause d
eath if left untreated. Endogenous Cushing's syndrome can be ACTH-depe
ndent or ACTH-independent. The ACTH-dependent type is more common and
is usually caused by diffuse hyperplasia on the adrenal cortex. This s
tudy investigated the response to low- and high-dose dexamethasone sup
pression testing of 30 adrenalectomized patients with Cushing's syndro
me, average age 37.3 +/- 9.7 years. Twenty-four (79.3%) patients were
female, and six (20.7%) were male. Bilateral adrenalectomy was perform
ed in 14 (48.2%) patients and unilateral adrenalectomy (nine and seven
right adrenalectomy) in 16 (51.8%). Two of the bilateral adrenalectom
ies were applied via endoscopic surgical approach. In the histopatholo
gical evaluation, diffuse hyperplasia was diagnosed in 13 (44.8%) pati
ents and nodular hyperplasia in eight (26.6%), three macronodular and
five micronodular hyperplasia. Adrenal cell adenoma was diagnosed in n
ine (28.6%) patients. Classic dexamethasone suppression testing was pe
rformed on all patients. Plasma levels of cortisol were not significan
tly decreased after low-dose testing, but plasma levels of cortisol we
re significantly decreased after high-dose testing in the diffuse hype
rplasia group. in summary, due to the pathological changes of the adre
nal cortex, dexamethasone suppression testing can differentiate betwee
n the two types of Cushing's syndrome.