Cushing s disease

Cushing s disease Cushing s syndrome Cushioning applications... 

Antagonists of glucocoiticoid and mineral ocorticoid activity have found iacieased use clinically ia the treatment of hypertension, Cushing s disease, and heightened iatraocular pressure. 

Other Potassium and Sodium Disorders. Potassium and/or sodium deficiency can lead to muscle weakness and sodium deficiency to nausea. Hyperkalemia resulting in cardiac arrest is possible from 18 g/d of potassium combined with inadequate kidney function. Faulty utilisation of K" and/or Na" can lead to Addison s or Cushing s disease. 

ACTH-secreting pituitary tumor (Cushing s disease)—70% of cases of endogenous Cushing s syndrome... 

Cushing s disease and adrenal carcinomas cause adrenal androgen hypersecretion in high enough concentrations to result in signs of androgen excess (such as acne, menstrual irregularities, and hirsutism) and cause virilization in women.4... 

Cushing s Disease) ACTH Syndrome Administration Adenoma Carcinoma... 

Metyrapone synthesis. Inhibits 11 -hydroxylase. 750 mg/day than 600 mg/day). Generally well tolerated. patients with hyperlipidemia. Used in Cushing s disease, ectopic... 

This suggestion receives support from the observation that chronic stress or glucocorticoid administration has been demonstrated to produce atrophy and death of vulnerable hippocampal neurons in rodents and primates. Furthermore, MRI studies have revealed reduced hippocampal volumes in patients with Cushing s disease... 

ACTH-dependent Cushing s syndrome is usually caused by overproduction of ACTH by the pituitary gland, causing adrenal hyperplasia (Cushing s disease). Pituitary adenomas account for about 80% of these cases. Ectopic ACTH-secreting tumors and nonneoplastic corticotropin hypersecretion are responsible for the remaining 20% of cases. 

Combination therapy with metyrapone and aminoglutethimide appears more effective than either agent alone for various etiologies of Cushing s disease with fewer side effects and is useful for inoperable patients. 

Ketoconazole inhibits a variety of cytochrome P450 enzymes, including 11-hydroxylase and 17-hydroxylase. It is highly effective in lowering cortisol in Cushing s disease, and patients can be maintained successfully on therapy for months to years. The most common adverse effects are reversible elevation of hepatic transaminases and GI upset. It can cause gynecomastia and lower plasma testosterone values. 

Cushing s disease, hyperparathyroidism, hyperthyroidism, hypothyroidism, hypoglycemia, hyponatremia, hyperkalemia, pheochromocytoma, vitamin B12 or folate deficiencies Neurologic... 

Endocrine or hormonal dysregulation (Addison s disease, Cushing s disease, hyper- or hypothyroidism, menstrual-related or pregnancy-related or perimenopausal mood disorders)... 

Addison s or Cushing s disease Myocardial infarction Diuretics... 

Malarkey, W.B. and Zvara, B.J., Interleukin-1-6 and other cytokines stimulate ACTH release from cultured pituitary cells of patients with Cushing s Disease, J. Clin. Endocrinol. Metab., 69, 196, 1989. 

If ACTH or cortisol is given to healthy subjects, it will cause a rise in the electrophoretic a2-fraction, which is mainly secondary to an increased Hp level in plasma this also holds for dogs (VI). In Cushing s disease slight hyperhaptoglobinemia is demonstrable (B3). 

Karl M, Lamberts SW, Koper JW, et al. (1996) Cushing s disease preceded by generalized glucocorticoid resistance clinical consequences of a novel, dominant-negative glucocorticoid receptor mutation. Proc Assoc Am Physicians. 108, 296-307. 

Endocrine disorders Adrenal Addison s disease and Cushing s disease Diabetes mellitus Parathyroid hyper-/hypo-Reproductive ovary/testicle failure Thyroid hyper-/hypo-... 

Etomidate hardly affects the autonomic nervous system. Since it inhibits cortisol synthesis, it can be used in the treatment of adrenocortical overactivity (Cushing s disease). 

Qassification Idiopathic osteoporosis type 1, occurring in postmenopausal females type 11, occurring in senescent males and females (>70 y). Secondary osteoporosis associated with primary disorders such as Cushing s disease, or induced by drugs, e.g chronic therapy with glucocorticoids or heparin. In these forms, the cause can be eliminated. 

Cushing s disease (caused by a pituitary ACTH-secreting adenoma) or Cushing s syndrome from an adrenal tumour is normally treated by surgical removal of the primary lesion where possible. Cases of ectopic ACTH syndrome associated with carcinoma of the bronchus cannot be treated surgically, and often benefit from medical therapy to control adrenal steroid excess. 

Mitotane (Lysodren) produces selective atrophy of the zona fasciculata and zona reticularis, which results in a decrease in the secretion of 17-hydroxy corticosteroids. Direct inhibition of cholesterol side-chain cleavage and 11 (3/18-hydroxylase activities has also been demonstrated. Mitotane is capable of inducing remission of Cushing s disease, but only after several weeks of therapy and at the price of severe gastrointestinal distress. Moreover, more than half of patients relapse following cessation of therapy. Other side effects include lethargy,... 

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