Publication
Síndroma de Cushing ACTH-dependente: estudo retrospectivo
| dc.contributor.author | Paiva, I | |
| dc.contributor.author | Ribeiro, C | |
| dc.contributor.author | Gomes, L | |
| dc.contributor.author | Baptista, C | |
| dc.contributor.author | Gomes, F | |
| dc.contributor.author | Rito, M | |
| dc.contributor.author | Rebelo, O | |
| dc.contributor.author | Marnoto, D | |
| dc.contributor.author | Moura, C | |
| dc.contributor.author | Leitão, F | |
| dc.contributor.author | Carvalheiro, M | |
| dc.date.accessioned | 2008-11-28T14:55:28Z | |
| dc.date.available | 2008-11-28T14:55:28Z | |
| dc.date.issued | 2004 | |
| dc.description.abstract | AIM: To evaluate the characteristics and outcomes of the patients diagnosed as ACTH-dependent Cushing syndrome, registered in the department. MATERIAL AND METHODS: We reviewed the files of forty-three patients followed from 1974 to 2002. RESULTS: A progressive rise in the number of patients diagnosed was found, being 80% females. Clinical suspicion was based mostly on the typical fat distribution; hirsutism and amenorrhoea were important in women. The more reliable diagnostic tests were: 11 pm cortisol, day curve of ACTH and cortisol, and dexamethasone suppression tests. The ACTH response to CRH during inferior petrosal sinus sampling permitted the diagnosis of ectopic source. In thirty-seven patients a pituitary adenoma was diagnosed. The three patients diagnosed before 1985 went for bilateral adrenalectomy (Nelson's syndrome in two); the others were submitted to transsphenoidal pituitary adenomectomy, obtaining remission in twenty six at the first operation and in two others at the second. Three patients had a recidive. Of the six patients with persistent disease (all treated with metyrapone or ketoconazole), three were submitted to radiotherapy, two to bilateral adrenalectomy, and one was waiting for surgery. Four patients had a bronchial carcinoid, successfully removed in three. One patient was lost to follow-up and another was still being evaluated. CONCLUSIONS: We found a positive evolution in the capacity to diagnose and treat these patients. Neurosurgical ability to achieve remission was 80% in the operated cases. More effective technical methods and drugs, as well as a multidisciplinary and dedicated medical team, lead to long lasting remissions in most of the patients. | en |
| dc.identifier.citation | Acta Med Port. 2004 Sep-Oct;17(5):367-74 | en |
| dc.identifier.uri | http://hdl.handle.net/10400.4/234 | |
| dc.language.iso | por | en |
| dc.publisher | Centro Editor Livreiro da Ordem dos Médicos | en |
| dc.subject | Síndrome de Cushing | en |
| dc.title | Síndroma de Cushing ACTH-dependente: estudo retrospectivo | en |
| dc.title.alternative | ACTH-dependent Cushing's syndrome: a revision of 43 cases | en |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| rcaap.rights | openAccess | |
| rcaap.type | article | en |