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Favorable long-term outcomes of bilateral adrenalectomy in Cushing's disease.
[congenital adrenal hyperplasia]
Bilateral
adrenalectomy
(
BADX
)
is
an
important
treatment
option
for
patients
with
Cushing
's
syndrome
(
CS
)
.
Our
aim
is
to
analyze
the
long
-term
outcomes
,
surgical
,
biochemical
,
and
clinical
as
well
as
morbidity
and
mortality
,
of
patients
who
underwent
BADX
.
A
total
of
50
patients
who
underwent
BADX
since
1990
in
two
German
centers
were
identified
.
Of
them
,
34
patients
had
Cushing
's
disease
(
CD
)
,
nine
ectopic
CS
(
ECS
)
,
and
seven
ACTH-independent
bilateral
adrenal
hyperplasia
(
BAH
)
.
Standardized
follow-up
examination
was
performed
in
36
patients
with
a
minimum
follow-up
time
of
6
months
after
BADX
and
a
median
follow-up
time
of
11
years
.
Surgical
morbidity
and
mortality
were
6
and
4
%
respectively
.
All
patients
were
found
to
be
in
remission
after
BADX
.
Almost
all
Cushing
'
s-
specific
comorbidities
except
for
psychiatric
diseases
improved
significantly
.
Health-related
quality
of
life
remained
impaired
in
45
.
0
%
of
female
and
16
.
7
%
of
male
patients
compared
with
a
healthy
population
.
The
median
number
of
adrenal
crises
per
100
patient-
years
was
four
.
Nelson
tumor
occurred
in
24
%
of
CD
patients
after
a
median
time
span
of
51
months
.
Long
-term
mortality
after
10
years
was
high
in
ECS
(
44
%
)
compared
with
CD
(
3
%
)
and
BAH
(
14
%
)
.
BADX
is
an
effective
and
relatively
safe
treatment
option
especially
in
patients
with
CD
.
The
majority
of
patients
experience
considerable
improvement
of
Cushing
's
symptoms
.
Diseases
Validation
Diseases presenting
"long-term outcomes"
symptom
acute rheumatic fever
alpha-thalassemia
aromatase deficiency
cholangiocarcinoma
classical phenylketonuria
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
dystrophic epidermolysis bullosa
esophageal squamous cell carcinoma
hirschsprung disease
homocystinuria without methylmalonic aciduria
kabuki syndrome
lamellar ichthyosis
omenn syndrome
phenylketonuria
proteus syndrome
trochlear dysplasia
von hippel-lindau disease
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