CLINICAL OBSERVATIONS ON CUSHING'S SYNDROME
1984 Volume 75 Issue 8 Pages 1280-1287
Details
1984 Volume 75 Issue 8 Pages 1280-1287
Twenty-one cases of Cushing's syndrome were experienced for the 20 years, 1962 to 1981.
Eighty per cent of the cases ranged in age from 20 to 39. The study comprised 16 cases of adenoma and 5 of hyperplasia.
Moon face, central obesity and hypertension were observed in all cases. Polycythemia, leucocytosis, hypokalemia and hypocalcemia were observed in 1, 6, 5 and 3 cases, respectively.
Urinary excretion of 17-OHCS for 24 hours and cortisol level in blood were high in all cases. ACTH level in blood was high in cases of hyperplasia, but was low or normal in cases of adenoma.
Metopirone® test and dexamethasone suppression test gave accurate diagnosis to 80 and 88 per cent of the cases, respectively. Concerning the localization of the lesions, PRP, CT scanning, ultrasonography and adrenal scanning showed accuracy rate of 50, 75, 80 and 93 per cent in diagnosis, respectively. Therefore, adrenal scanning seems to be most efficient.
In 9 cases of adenoma, postoperative replacements of glucocorticoid were done for 10 days to one year and 6 months. In 4 cases out of the 9, the release from glucocorticoid dependency could be done within one month. One case was released from glucocorticoid dependency by hyperbaric oxygenation. Cases of hyperplasia who underwent total adrenalectomy did not show typical Nelson's syndrome with or without hypophyseal irradiation. Two cases out of 15 revealed hypertension even 5 years after operation
