Rare Diseases Symptoms Automatic Extraction
Home
A random Abstract
Our Project
Our Team
Impact and timing of bilateral adrenalectomy for refractory adrenocorticotropic hormone-dependent Cushing’s syndrome.
[cushing syndrome]
In
patients
with
refractory
adrenocorticotropic
hormone-dependent
Cushing
’
s
syndrome
,
we
evaluated
steroidogenesis
inhibition
(
SI
)
and
bilateral
adrenalectomy
(
BA
)
to
predict
which
patients
might
benefit
most
from
each
treatment
modality
.
Clinical
data
from
patients
treated
1970
-
2012
were
reviewed
retrospectively
by
treatment
group
(
SI
or
SI
+
BA
)
.
Validated
severity
scales
were
used
to
calculate
metabolic
(
M
)
score
(
hypokalemia
,
hyperglycemia
,
hypertension
,
proximal
muscle
weakness
)
and
adverse
events
(
AE
)
score
(
thrombosis
,
fracture
,
infection
)
.
A
total
of
65
patients
(
16
pituitary
,
49
ectopic
)
were
treated
with
SI
+
BA
(
n
=
21
,
32
%
)
or
SI
alone
(
n
=
44
,
68
%
)
.
Presenting
M
scores
and
source
of
adrenocorticotropic
hormone
excess
(
ectopic
versus
pituitary
)
were
similar
.
Both
groups
improved
metabolically
after
treatment
.
Over
one
-
third
of
AEs
in
the
SI
+
BA
group
occurred
within
12
months
of
presentation
.
Half
(
n
=
24
,
55
%
)
of
the
patients
treated
with
SI
died
(
median
survival
,
24
.
0
months
)
.
Steroid
excess
contributed
to
71
%
of
complications
.
Six
SI
+
BA
patients
died
(
29
%
)
,
including
all
3
patients
with
recurrent
Cushing
’
s
syndrome
after
BA
.
Minor
perioperative
complications
occurred
in
7
patients
(
33
%
)
.
Posttreatment
M
and
AE
scores
improved
for
all
patients
and
70
%
of
AEs
occurred
in
SI
+
BA
patients
within
12
months
of
presentation
,
emphasizing
the
importance
of
early
operative
intervention
.
These
data
argue
for
the
safety
and
efficacy
of
early
BA
in
selected
patients
with
uncontrollable
Cushing
’
s
syndrome
.
Diseases
Validation
Diseases presenting
"proximal muscle weakness"
symptom
cushing syndrome
focal myositis
This symptom has already been validated