| Title | "Subclinical Cushing's syndrome" is not subclinical: improvement after adrenalectomy in 9 patients. | | Author(s) | Mitchell IC, Auchus RJ, Juneja K, Chang AY, Holt SA, Snyder WH, Nwariaku FE | | Institution | Division of Gastrointestinal and Endocrine Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9156, USA. | | Source | Surgery 2007 Dec; 142(6):900-5. | | MeSH | Adenoma
Adrenal Cortex
Adrenal Cortex Neoplasms
Adrenalectomy
Adult
Aged
Aged, 80 and over
Cushing Syndrome
Female
Humans
Hydrocortisone
Hyperplasia
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Treatment Outcome
| | Abstract | BACKGROUND: A subgroup of patients with adrenal cortisol hypersecretion fails to meet the biochemical criteria for Cushing's syndrome. Appropriate therapy for this entity, subclinical Cushing's syndrome (subclinical CS), is unclear. We examined outcomes for patients who underwent unilateral adrenalectomy for subclinical CS.
METHODS: Between 2003 and 2006, all patients who underwent adrenalectomy for cortisol hypersecretion caused by an adrenal mass were examined. We analyzed biochemical, metabolic, and clinical outcomes.
RESULTS: Overall, 24 patients underwent adrenalectomy for adrenal cortisol hypersecretion, of which 9 were found to have subclinical CS. Median serum cortisol was 2.0 microg/dL (range, 1.1-6.1) after 1-mg overnight dexamethasone suppression testing. Suspicious clinical findings on preoperative examination included skin bruising, unexplained weight gain, proximal muscle weakness, abnormal fat pads, skin thinning, fatigue, and facial plethora. During a median follow-up period of 5 months (range, 1-30 months), all 8 patients with easy bruising noted resolution postoperatively. Fatigue improved in 4 of 5 patients, muscle weakness in 6 of 8 patients, and weight in 7 of 9 patients, with a median body mass index change of -2.0 kg/m(2) (range, -7.1 to +0.5 kg/m(2)).
CONCLUSION: Adrenalectomy improves clinical and metabolic parameters for many patients with subclinical CS. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 18063074 |
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