The aim was to analyze the postsurgical duration of adrenal insufficiency of patients with Cushing’s disease (CD), adrenal CS and ectopic CS.
Design:
We performed a retrospective analysis based on the case records of 230 CS patients in our tertiary referral center treated from 1983 to 2014. The mean follow-up time was 8 years.
The probability of recovering adrenal function within a 5 years follow-up differed significantly between subtypes (p=0.001). It was 82 % in ectopic CS, 58 % in Cushing’s disease and 38 % in adrenal CS. In the total cohort with restored adrenal function (n=52) the median time to recovery differed between subtypes: 0.6 (IQR 0.03–1.1) years in ectopic CS, 1.4 (IQR 0.9–3.4) years in CD, and 2.5 (IQR 1.6–5.4) years in adrenal CS (p=0.002). In CD the Cox proportional-hazards model showed that the probability of recovery was associated with younger age (hazard ratio 0.896, 95% CI 0.822–0.976, p=0.012), independently of sex, BMI, duration of symptoms, and basal ACTH and cortisol levels. There was no correlation with length and extend of hypercortisolism or postoperative glucocorticoid replacement doses.
Conclusions:
Time to recovery of adrenal function is dependent on the underlying etiology of CS.
- 1Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, Germany;
- 2Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Germany;
- 3Chirurgische Klinik und Poliklinik – Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Germany;
- 4Klinik für Neurochirurgie, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, Germany;
- 5IMSE, Klinikum rechts der Isar der TU München, München, Germany
From http://press.endocrine.org/doi/abs/10.1210/jc.2014-3632
Filed under: adrenal, adrenal crisis, Cushing's, pituitary | Tagged: abstract, adrenal Cushing's, adrenal insufficiency, Cushing's Syndrome, ectopic, hypercortisolism, surgery |
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