Endocrinology and Metabolism

Original Article

Hypothalamus and Pituitary Gland Big Data Articles (National Health Insurance Service Database)
Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea: Jin Sun Park, Soo Jin Yun, Jung Kuk Lee, So Young Park, Sang Ouk Chin; Endocrinol Metab. 2021;36(3):688-696. Published online June 28, 2021; DOI: https://doi.org/10.3803/EnM.2021.1000

5,813 View
153 Download
4 Web of Science
5 Crossref

Background
Only a few studies have established the epidemiology of prolactinoma and Cushing’s disease in Korea. Furthermore, the incidence of these disease are increasing than before associated with the development of technologies. This study was designed to evaluate the epidemiology of prolactinoma and Cushing’s disease and their survival analysis according to treatment.
Methods
The nationwide, population-based study evaluated incidence and prevalence of prolactinoma and Cushing’s disease using de-identified claims data in The Korean Health Insurance Review and Assessment Service database between 2013 and 2017. The survival analysis investigated regarding treatment over a period of 6 years. A log-rank test and Cox proportional hazard regression analysis were used.
Results
The 6,056 patients with newly diagnosed prolactinoma and 584 patients with Cushing’s disease were recorded between 2013 and 2017. The annual incidence of prolactinoma was 23.5 cases per million, and its prevalence was 82.5 cases per million, and 2.3 cases per million/year and 9.8 cases per million for Cushing’s disease. The survival benefit was insignificant in prolactinoma according to treatment, but treatment of Cushing’s disease ameliorated the survival rate significantly.
Conclusion
Overall, the incidence of prolactinoma and Cushing’s disease was similar with those found previously, but the prevalence of two diseases were inconsistent when compared with the early studies. The present study also proposed necessity of treatment in Cushing’s disease for improving the survival rate.

Citations

Citations to this article as recorded by

For the Forthcoming Winning Shot in the Battle against Cushing Disease
Sang Ouk Chin
Endocrinology and Metabolism.2024; 39(4): 573. CrossRef
The 24-Hour Urinary Cortisol/Urinary Creatinine Ratio Helps Differentiate Cushing's Syndrome from Simple Obesity
Meng Wang, Xueting Sun, Shiwei Li, Xin Li, Jingqiu Cui
Endocrine Practice.2024;[Epub] CrossRef
Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
Endocrinology and Metabolism.2023; 38(1): 10. CrossRef
Cushing Syndrome
Martin Reincke, Maria Fleseriu
JAMA.2023; 330(2): 170. CrossRef
Clinical Biology of the Pituitary Adenoma
Shlomo Melmed, Ursula B Kaiser, M Beatriz Lopes, Jerome Bertherat, Luis V Syro, Gerald Raverot, Martin Reincke, Gudmundur Johannsson, Albert Beckers, Maria Fleseriu, Andrea Giustina, John A H Wass, Ken K Y Ho
Endocrine Reviews.2022; 43(6): 1003. CrossRef

Case Reports

A Case with Isolated ACTH Deficiency.: Myoung Sik Kim, Byung Doo Lee, Sang Min Shin, Young Il Kim, Byung Oh Jeong, Hong Jib Choi, Phil Ho Kim, Kyung Soo Ko, Jae Hong Park; J Korean Endocr Soc. 1996;11(4):538-543. Published online November 7, 2019

1,342 View
55 Download

Abstract PDF: Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency. Adrenal crisis in isolated ACTH deficiency is less common compared to primary adrenal insufficiency, but isolated ACTH deficiency is an important cause of hypoglycemia. Recently we experienced a 41-year-old man admitted because of mental confusion. On admission, plasma glucose and sodium concentration were 1.7, 132 mmol/L, respectively. Basal plasma ACTH and cortisol levels were low and other pituitary hormone showed normal response to combined pituitary stimulation test except growth hormone. Plasma ACTH concentration remained low even after intravenous injection of ovine corticotropin releasing factor. It suggest that the defect of ACTH secretion was apparently due to intrinsic pituitary rather than hypothalamic disease. The sellar CT showed the fossa to be filled by cerebrospinal fluid. After treatment with glucocorticoid, he had no further evidence of hypoglycemia and hyponatremia. In conclusion, we report a case of isolated ACTH deficiency with empty sella.

A Case of Isolated ACTH Deficiency.: Sang Jin Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 1995;10(4):445-450. Published online November 7, 2019

1,224 View
23 Download

Abstract PDF: solated ACTH deficiency is a very uncommon cause of hypoadrenocorticism, with less than 200 cases reported in the literatures. The clinical presentation can be similar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The diagnosis is established by demonstrating hypocortisolism with undetectable serum levels of ACTH, normal adrenal responsiveness to prolonged ACTH infusion, and an absent ACTH response to insulin-induced hypoglycemia. Other endocrine function is normal.We experienced a case of isolated ACTH deficiency in 34 years old female who was admitted due to fever and drowsy mentality.So we present this case with a review of literatures.

Original Articles

Cushing's Disease Due to ACTH Producing Pituitary Carcinoma.: Young Kee Shong, Joong Yeol Park, Ghi Su Kim, Won Kyoung Cho, Jung Kyo Lee, Ghee Young Choe, Mun Ho Lee, Ki Up Lee; J Korean Endocr Soc. 1994;9(2):136-140. Published online November 6, 2019

1,191 View
20 Download

Abstract PDF: Primary carcinoma of the pituitary is only rarely reported. About half of the reported cases are nonfunctional. It is generally agreed that the presence of distant metastasis is required to clearly establish the diagnosis of pituitary carcinoma. We have experienced a case of ACTH-producing pituitary carcinoma causing Cushing's syndrome which could be diagnosed by histologic features only without evidence of distant metastasis. A 35-year-old female with Cushingoid appearance was diagnosed as Cushing's disease after biochemical and neuroradiological evaluation. Near total removal of the pituitary tumor was performed. By histopathologic examination, the tumor revealed evidences of histological malignancy such as prominent nuclear pleomorphism, frequent mitoses and extensive tumor necrosis. Pseudosarcomatous components were also noted. By immunohistochemical studies, the tumor cells expressed ACTH. However, there was no evidence of distant metastasis at the initial operation. She was diagnosed as having ACTH producing pituitary carcinoma by histologic feature only. One month later, she complained progressive nausea and vomiting, and follow-up brain MRI revealed regrowing pituitary mass. She was reoperated and near total tumor bulk was removed again followed by radiotherapy with 5580 rads. Four month after the second operation, she developed generalized tonic clonic seizure. Brain CT showed multiple enhancing nodules on left temporal and frontal lobes, and around falx cerebri. She refused further treatment and was managed only with anticonvalsants. About month after discharge she died at home.

Endocrine Research
Effects of Oxytocin on Cell Proliferation in a Corticotroph Adenoma Cell Line: Jung Soo Lim, Young Woo Eom, Eun Soo Lee, Hyeong Ju Kwon, Ja-Young Kwon, Junjeong Choi, Choon Hee Chung, Young Suk Jo, Eun Jig Lee; Endocrinol Metab. 2019;34(3):302-313. Published online September 26, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.3.302

6,413 View
80 Download
3 Web of Science
2 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background

Oxytocin (OXT) has been reported to act as a growth regulator in various tumor cells. However, there is a paucity of data on the influence of OXT on cell proliferation of corticotroph adenomas. This study aimed to examine whether OXT affects cell growth in pituitary tumor cell lines (AtT20 and GH3 cells) with a focus on corticotroph adenoma cells.

Methods

Reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay were conducted with AtT20 cells to confirm the effects of OXT on hormonal activity; flow cytometry was used to assess changes in the cell cycle after OXT treatment. Moreover, the impact of OXT on proliferating cell nuclear antigen (PCNA), nuclear factor κB, and mitogen-activated protein kinase signaling pathway was analyzed by Western blot.

Results

OXT treatment of 50 nM changed the gene expression of OXT receptor and pro-opiomelanocortin within a short time. In addition, OXT significantly reduced adrenocorticotropic hormone secretion within 1 hour. S and G2/M populations of AtT20 cells treated with OXT for 24 hours were significantly decreased compared to the control. Furthermore, OXT treatment decreased the protein levels of PCNA and phosphorylated extracellular-signal-regulated kinase (P-ERK) in AtT20 cells.

Conclusion

Although the cytotoxic effect of OXT in AtT20 cells was not definite, OXT may blunt cell proliferation of corticotroph adenomas by altering the cell cycle or reducing PCNA and P-ERK levels. Further research is required to investigate the role of OXT as a potential therapeutic target in corticotroph adenomas.

Citations

Citations to this article as recorded by

Increased proliferation and neuronal fate in prairie vole brain progenitor cells cultured in vitro: effects by social exposure and sexual dimorphism
Daniela Ávila-González, Italo Romero-Morales, Lizette Caro, Alejandro Martínez-Juárez, Larry J. Young, Francisco Camacho-Barrios, Omar Martínez-Alarcón, Analía E. Castro, Raúl G. Paredes, Néstor F. Díaz, Wendy Portillo
Biology of Sex Differences.2023;[Epub] CrossRef
Anterior pituitary gland synthesises dopamine from l‐3,4‐dihydroxyphenylalanine (l‐dopa)
Santiago Jordi Orrillo, Nataly de Dios, Antonela Sofía Asad, Fernanda De Fino, Mercedes Imsen, Ana Clara Romero, Sandra Zárate, Jimena Ferraris, Daniel Pisera
Journal of Neuroendocrinology.2020;[Epub] CrossRef

Review Articles

Recent Progress in the Medical Therapy of Pituitary Tumors: Fabienne Langlois, Shirley McCartney, Maria Fleseriu; Endocrinol Metab. 2017;32(2):162-170. Published online May 19, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.162

6,390 View
69 Download
27 Web of Science
27 Crossref

Abstract PDF PubReader ePub

Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD). In the case of non-functioning pituitary adenomas (NFAs), pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies. For pituitary carcinomas and atypical adenomas, medical therapy, including chemotherapy, acts as an adjuvant to surgery and radiation therapy, which is often required to control these aggressive tumors. In the last decade, knowledge about the pathophysiological mechanisms of various pituitary adenomas has increased, thus novel medical therapies that target specific pathways implicated in tumor synthesis and hormonal over secretion are now available. Advancement in patient selection and determination of prognostic factors has also helped to individualize therapy for patients with pituitary tumors. Improvements in biochemical and “tumor mass” disease control can positively affect patient quality of life, comorbidities and overall survival. In this review, the medical armamentarium for treating CD, acromegaly, prolactinomas, NFA, and carcinomas/aggressive atypical adenomas will be presented. Pharmacological therapies, including doses, mode of administration, efficacy, adverse effects, and use in special circumstances are provided. Medical therapies currently under clinical investigation are also briefly discussed.

Citations

Citations to this article as recorded by

Multiomics Approach to Acromegaly: Unveiling Translational Insights for Precision Medicine
Kyungwon Kim, Cheol Ryong Ku, Eun Jig Lee
Endocrinology and Metabolism.2023; 38(5): 463. CrossRef
PDCD10 promotes the aggressive behaviors of pituitary adenomas by up-regulating CXCR2 and activating downstream AKT/ERK signaling
Jingdian Liu, Junwen Wang, Weidong Tian, Yu Xu, Ran Li, Kai Zhao, Chao You, Yuan Zhu, Joerg Walter Bartsch, Hongquan Niu, Huaqiu Zhang, Kai Shu, Ting Lei
Aging.2022; 14(15): 6066. CrossRef
LncRNA MYMLR promotes pituitary adenoma development by upregulating carbonyl reductase 1 via sponging miR-197-3p
Tuo Wang, Ping Mao, Yan Zhang, Bo Cui, Mao-De Wang, Ya Li, Ke Gao
Anti-Cancer Drugs.2022; 33(10): 1058. CrossRef
Comparative Proteomic Study Shows the Expression of Hint-1 in Pituitary Adenomas
Carolina Carrillo-Najar, Daniel Rembao-Bojórquez, Martha L. Tena-Suck, Sergio Zavala-Vega, Noemí Gelista-Herrera, Miguel A. Ramos-Peek, Juan L. Gómez-Amador, Febe Cazares-Raga, Fidel de la Cruz Hernández-Hernández, Alma Ortiz-Plata
Diagnostics.2021; 11(2): 330. CrossRef
Recent Understanding and Future Directions of Recurrent Corticotroph Tumors
José Miguel Hinojosa-Amaya, César Ernesto Lam-Chung, Daniel Cuevas-Ramos
Frontiers in Endocrinology.2021;[Epub] CrossRef
What to Do with Incidentally Discovered Pituitary Abnormalities?
Fabienne Langlois, Maria Fleseriu
Medical Clinics of North America.2021; 105(6): 1081. CrossRef
Aggressive prolactinoma (Review)
Ana Valea, Florica Sandru, Aida Petca, Mihai Dumitrascu, Mara Carsote, Razvan-Cosmin Petca, Adina Ghemigian
Experimental and Therapeutic Medicine.2021;[Epub] CrossRef
Diagnosis and Treatment of Pituitary Adenomas
O. A. Beylerli, Zhao Shiguang, I. F. Gareev, Chen Xin
Creative surgery and oncology.2020; 9(4): 311. CrossRef
Management of patients with persistent or recurrent Cushing’s disease after initial pituitary surgery
Cristina Capatina, José Miguel Hinojosa-Amaya, Catalina Poiana, Maria Fleseriu
Expert Review of Endocrinology & Metabolism.2020; 15(5): 321. CrossRef
Modern principles of the diagnosis and conservative treatment of Cushing disease
Ashraf Abdali, Ludmila Astafeva, Pavel Kalinin, Yuriy Trunin, I. V. Chernov, G. E. Сhmutin, Abdali Badshahzar, GulSharif Sherzad, Simfukwe Keith
Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery).2020; (10): 67. CrossRef
Effects of Oxytocin on Cell Proliferation in a Corticotroph Adenoma Cell Line
Jung Soo Lim, Young Woo Eom, Eun Soo Lee, Hyeong Ju Kwon, Ja-Young Kwon, Junjeong Choi, Choon Hee Chung, Young Suk Jo, Eun Jig Lee
Endocrinology and Metabolism.2019; 34(3): 302. CrossRef
Pituitary Adenomas: What Are the Key Features? What Are the Current Treatments? Where Is the Future Taking Us?
Domenico Solari, Rosario Pivonello, Chiara Caggiano, Elia Guadagno, Carmela Chiaramonte, Giovanni Miccoli, Luigi M. Cavallo, Marialaura Del Basso De Caro, Annamaria Colao, Paolo Cappabianca
World Neurosurgery.2019; 127: 695. CrossRef
Expression of Cyclin E/Cdk2/p27Kip1 in Growth Hormone Adenomas
Wei Dong, Haibo Zhu, Hua Gao, Wenjian Shi, Yu Zhang, Hongyun Wang, Chuzhong Li, Guidong Song, Yazhuo Zhang
World Neurosurgery.2019; 121: e45. CrossRef
Acromegaly
Annamaria Colao, Ludovica F. S. Grasso, Andrea Giustina, Shlomo Melmed, Philippe Chanson, Alberto M. Pereira, Rosario Pivonello
Nature Reviews Disease Primers.2019;[Epub] CrossRef
Differenzialdiagnostik und Therapie der Hypophysenadenome
M. Hlaváč, F. Sommer, G. Karpel-Massler, R. Wirtz, T. Hoffmann, A. Paľa
HNO.2019; 67(4): 307. CrossRef
Medical Management of Cushing’s Syndrome: Current and Emerging Treatments
José Miguel Hinojosa-Amaya, Daniel Cuevas-Ramos, Maria Fleseriu
Drugs.2019; 79(9): 935. CrossRef
Aggressive and Malignant Prolactinomas
Nicoleta Cristina Olarescu, Luis G. Perez-Rivas, Federico Gatto, Thomas Cuny, Maria A. Tichomirowa, Gianluca Tamagno, Manuel D. Gahete
Neuroendocrinology.2019; 109(1): 57. CrossRef
New Insights in Cushing Disease Treatment With Focus on a Derivative of Vitamin A
Mariana Fuertes, Julieta Tkatch, Josefina Rosmino, Leandro Nieto, Mirtha Adriana Guitelman, Eduardo Arzt
Frontiers in Endocrinology.2018;[Epub] CrossRef
Prenatal alcohol exposure increases the susceptibility to develop aggressive prolactinomas in the pituitary gland
Shaima Jabbar, Kenneth Reuhl, Dipak K. Sarkar
Scientific Reports.2018;[Epub] CrossRef
Aggressive and malignant pituitary tumours: state-of-the-art
Dorota Dworakowska, Ashley B Grossman
Endocrine-Related Cancer.2018; 25(11): R559. CrossRef
Epidemiología y caracterización general de los tumores cerebrales primarios en el adulto
Maria Isabel Ocampo Navia, Juan Carlos Gómez Vega, Oscar Hernando Feo Lee
Universitas Médica.2018;[Epub] CrossRef
Triptolide inhibits pituitary adenoma cell viability, migration and invasion via ADAM12/EGFR signaling pathway
Junwen Wang, Zhuo Zhang, Ran Li, Wei Sun, Juan Chen, Huaqiu Zhang, Kai Shu, Ting Lei
Life Sciences.2018; 194: 150. CrossRef
Emerging roles of bexarotene in the prevention, treatment and anti-drug resistance of cancers
Danyang Shen, Xiaoming Yu, Yan Wu, Yuanlei Chen, Gonghui Li, Feng Cheng, Liqun Xia
Expert Review of Anticancer Therapy.2018; 18(5): 487. CrossRef
New Molecular Targets for Treatment of Cushing’s Disease
Elizabeth Foulkes, John Newell-Price
Endocrinology and Metabolism Clinics of North America.2018; 47(2): 367. CrossRef
Pituitary-Directed Therapies for Cushing’s Disease
Fabienne Langlois, Jennifer Chu, Maria Fleseriu
Frontiers in Endocrinology.2018;[Epub] CrossRef
Updates in Diagnosis and Treatment of Acromegaly
Roula Zahr, Maria Fleseriu
European Endocrinology.2018; 14(2): 57. CrossRef
Root cause analysis of diagnostic and surgical failures in the treatment of suspected Cushing’s disease
Hasan A. Zaidi, David L. Penn, David J. Cote, Edward R. Laws
Journal of Clinical Neuroscience.2018; 53: 153. CrossRef

Adrenal gland
Clinical Guidelines for the Diagnosis and Treatment of Cushing's Disease in Korea: Kyu Yeon Hur, Jung Hee Kim, Byung Joon Kim, Min-Seon Kim, Eun Jig Lee, Sung-Woon Kim; Endocrinol Metab. 2015;30(1):7-18. Published online March 27, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.1.7

8,683 View
203 Download
11 Web of Science
16 Crossref

Abstract PDF PubReader

Cushing's disease (CD) is a rare disorder characterized by the overproduction of adrenocorticotropic hormone due to a pituitary adenoma that ultimately stimulates excessive cortisol secretion from the adrenal glands. Prior to the detection of pituitary adenomas, various clinical signs of CD such as central obesity, moon face, hirsutism, and facial plethora are usually already present. Uncontrolled hypercortisolism is associated with metabolic, cardiovascular, and psychological disorders that result in increased mortality. Hence, the early detection and treatment of CD are not only important but mandatory. Because its clinical manifestations vary from patient to patient and are common in other obesity-related conditions, the precise diagnosis of CD can be problematic. Thus, the present set of guidelines was compiled by Korean experts in this field to assist clinicians with the screening, diagnoses, and treatment of patients with CD using currently available tests and treatment modalities.

Citations

Citations to this article as recorded by

Bone mineral density in patients with Cushing’s syndrome
Aysun Seker, Dilek Gogas Yavuz
Marmara Medical Journal.2024; 37(2): 185. CrossRef
Diet quality and dietary acid load in relation to cardiovascular disease mortality: Results from Fasa PERSIAN cohort study
Sahar Fereidouni, Najmeh Hejazi, Reza Homayounfar, Mojtaba Farjam
Food Science & Nutrition.2023; 11(3): 1563. CrossRef
Role of computed tomography in predicting adrenal adenomas with cortisol hypersecretion
Chan Kyo Kim, Kyung A Kang, Young Lyun Oh, Sung Yoon Park
The British Journal of Radiology.2023;[Epub] CrossRef
Dietary acid load and mortality from all causes, CVD and cancer: results from the Golestan Cohort Study
Ehsan Hejazi, Hadi Emamat, Maryam Sharafkhah, Atoosa Saidpour, Hossein Poustchi, Sadaf Sepanlou, Masoud Sotoudeh, Sanford Dawsey, Paolo Boffetta, Christian C Abnet, Farin Kamangar, Arash Etemadi, Akram Pourshams, Akbar Fazeltabar Malekshah, Paul Berennan,
British Journal of Nutrition.2022; 128(2): 237. CrossRef
Forty Years Together, New Leap Forward! The 40th Anniversary of the Korean Endocrine Society
Jong Chul Won, Ki-Hyun Baek
Endocrinology and Metabolism.2022; 37(6): 851. CrossRef
Pituitary adenomas: current principles of diagnosis and treatment
L. I. Astafyeva, I. V. Chernov, I. V. Chekhonin, E. I. Shults, I. N. Pronin, P. L. Kalinin
Russian journal of neurosurgery.2021; 22(4): 94. CrossRef
Metabolic changes in serum steroids for diagnosing and subtyping Cushing’s syndrome
Chang Ho Ahn, Chaelin Lee, Jaeyoon Shim, Sung Hye Kong, Su-jin Kim, Yong Hwy Kim, Kyu Eun Lee, Chan Soo Shin, Jung Hee Kim, Man Ho Choi
The Journal of Steroid Biochemistry and Molecular Biology.2021; 210: 105856. CrossRef
Application of different variants of endoscopic transphenoidal removal of corticotropinomas in order to increase the frequency and duration of remission
A. Ashraf, I. V. Chernov, A. N. Shkarubo, M. A. Kutin, D. V. Fomichev, O. I. Sharipov, Yu. Yu. Trunin, D. N. Andreev, A. A. Abdilatipov, L. I. Astafieva, B. Abdali, A. B. Kurnosov, G. E. Chmutin, Kalinin P. L. Kalinin P. L.
Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery).2021; (2): 143. CrossRef
Modern aspects of surgery for cushing’s disease
A. Abdali, L.I. Astafeva, Yu.Yu. Trunin, I.V. Chernov, Yu.G. Sidneva, A.A. Abdilatipov, P.L. Kalinin
Voprosy neirokhirurgii imeni N.N. Burdenko.2021; 85(4): 111. CrossRef
Pituitary microadenomas — current diagnostic and treatment methods
L.I. Astafyeva, B.A. Kadashev, Yu.G. Sidneva, I.V. Chernov, P.L. Kalinin
Voprosy neirokhirurgii imeni N.N. Burdenko.2020; 84(2): 110. CrossRef
Usefulness of prolactin measurement in inferior petrosal sinus sampling with desmopressin for Cushing’s syndrome
Hamideh Akbari, Mohammad Ghorbani, Maryam Kabootari, Ali Zare Mehrjardi, Mohammad Reza Mohajeri Tehrani, Mojtaba Malek, Mohammad E. Khamseh
British Journal of Neurosurgery.2020; 34(3): 253. CrossRef
Hormonal aggressiveness according to the expression of cellular markers in corticotroph adenomas
Jung Soo Lim, Mi-Kyung Lee, Eunhee Choi, Namki Hong, Soo Il Jee, Sun Ho Kim, Eun Jig Lee
Endocrine.2019; 64(1): 147. CrossRef
Clinical Parameters to Distinguish Silent Corticotroph Adenomas from Other Nonfunctioning Pituitary Adenomas
Daham Kim, Cheol Ryong Ku, Se Hee Park, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Eun Jig Lee
World Neurosurgery.2018; 115: e464. CrossRef
Blood Tests for the Diagnosis of Adrenal Diseases
Seon-Ah Cha, Sung-Dae Moon
The Korean Journal of Medicine.2018; 93(6): 532. CrossRef
Choosing wisely: la lista del gruppo di studio Endocrinologia e Malattie del Metabolismo della Società Italiana di Patologia Clinica e Medicina di Laboratorio
Romolo M. Dorizzi, Anna Ferrari, Marina Vitillo, Beatrice Caruso, Claudio Cocco, Erennio Ciotoli, Federica D’Aurizio, Elisa Esposito, Germana Giannone, Giulio Ozzola, Ottavia Porzio, Emanuela Toffalori, Renato Tozzoli
La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine.2016; 12(2): 81. CrossRef
Surgical Management of Adrenocorticotropic Hormone-Secreting Pituitary Adenomas
Edwin S Kulubya, Daniel A Donoho, John D Carmichael, Gabriel Zada
International Journal of Endocrine Oncology.2016; 3(1): 41. CrossRef

Case Report

Thyroid
Medullary Thyroid Carcinoma with Ectopic Adrenocorticotropic Hormone Syndrome: Hong Seok Choi, Min Joo Kim, Chae Ho Moon, Jong Ho Yoon, Ha Ra Ku, Geon Wook Kang, Im Il Na, Seung-Sook Lee, Byung-Chul Lee, Young Joo Park, Hong Il Kim, Yun Hyi Ku; Endocrinol Metab. 2014;29(1):96-100. Published online March 14, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.1.96

4,528 View
41 Download
4 Web of Science
5 Crossref

Abstract PDF PubReader

Ectopic adrenocorticotropic hormone (ACTH) syndrome is caused most frequently by a bronchial carcinoid tumor or by small cell lung cancer. Medullary thyroid carcinoma (MTC) is a rare etiology of ectopic ACTH syndrome. We describe a case of Cushing syndrome due to ectopic ACTH production from MTC in a 48-year-old male. He was diagnosed with MTC 14 years ago and underwent total thyroidectomy, cervical lymph node dissection and a series of metastasectomies. MTC was confirmed by the pathological examination of the thyroid and metastatic mediastinal lymph node tissues. Two years after his last surgery, he developed Cushingoid features, such as moon face and central obesity, accompanied by uncontrolled hypertension and new-onset diabetes. The laboratory results were compatible with ectopic ACTH syndrome. A bilateral adrenalectomy improved the clinical and laboratory findings that were associated with Cushing syndrome. This is the first confirmed case of ectopic ACTH syndrome caused by MTC in Korea.

Citations

Citations to this article as recorded by

Medullary thyroid carcinoma with ACHT-dependent Cushing's syndrome: Therapeutic possibilities
Dušan Ilić, Sanja Ognjanović, Bojana Popović, Valentina Elezović-Kovačević, Milica Opalić-Palibrk, Lena Radić, Katarina Krstić, Đuro Macut
Medicinski glasnik Specijalne bolnice za bolesti štitaste žlezde i bolesti metabolizma.2024; 29(93): 46. CrossRef
Medullary Thyroid Cancer with Ectopic Cushing's Syndrome: A Case Report and Systematic Review of Detailed Cases from the Literature
Andrea Corsello, Vittoria Ramunno, Pietro Locantore, Giovanni Pacini, Esther Diana Rossi, Francesco Torino, Alfredo Pontecorvi, Carmela De Crea, Rosa Maria Paragliola, Marco Raffaelli, Salvatore Maria Corsello
Thyroid.2022; 32(11): 1281. CrossRef
Mucosal Neuroma Cues for Endocrine Emergency Treatment
Gyu Gang Choi, Hwan Jin Lee, Hyo Jin Han, Young Beom Jeong, Heung Bum Lee, Ji Hyun Park
Endocrinology and Metabolism.2021; 36(6): 1312. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef
Rapid response of hypercortisolism to vandetanib treatment in a patient with advanced medullary thyroid cancer and ectopic Cushing syndrome
Fabián Pitoia, Fernanda Bueno, Angélica Schmidt, Sabrina Lucas, Graciela Cross
Archives of Endocrinology and Metabolism.2015; 59(4): 343. CrossRef

Review Article

ACTH-Independent Macronodular Adrenal Hyperplasia.: Livia M Mermejo, Tania L Mazzuco, Solange Grunenwald, Maria Candida B V Fragoso, Isabelle Bourdeau, Andre Lacroix; Endocrinol Metab. 2011;26(1):1-11. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.1

2,492 View
49 Download
3 Crossref

Abstract PDF

ACTH-independent macronodular adrenal hyperplasia (AIMAH) is an uncommon cause of Cushing's syndrome (CS). The pathophysiology of this disorder is heterogeneous in its molecular origin and also in its clinical presentation. AIMAH can present mainly as an incidental radiological finding with sub-clinical CS or rarely with overt CS. In a few familial cases reported with AIMAH, specific aberrant G-protein coupled receptors were expressed in the adrenals of all affected members, but sporadic cases are more common. The aberrant adrenal function of G-protein coupled receptors can lead to cell proliferation and abnormal regulation of steroidogenesis. Unilateral or bilateral adrenalectomy has been the most frequently used treatment for this adrenal disorder; alternatively, the identification of aberrant receptors using in vivo protocol of investigation can offer specific pharmacological approach to control abnormal steroidogenesis and possibly prevent AIMAH progression.

Citations

Citations to this article as recorded by

Cushing Syndrome Caused by ACTH-independent Macronodular Adrenal Hyperplasia
Yeon-Kyung Choi, In-Ryang Hwang, Jung-Bum Seo, Ji Yun Jeong, Jung-Guk Kim
The Korean Journal of Medicine.2017; 92(2): 190. CrossRef
Primary bilateral adrenal nodular disease with Cushing's syndrome: varying aetiology
Kush Dev Singh Jarial, Rama Walia, Uma Nahar, Anil Bhansali
BMJ Case Reports.2017; : bcr-2017-220154. CrossRef
Multiple aberrant hormone receptors in Cushing's syndrome
Nada El Ghorayeb, Isabelle Bourdeau, André Lacroix
European Journal of Endocrinology.2015; 173(4): M45. CrossRef

Case Reports

Ectopic ACTH Syndrome with Bilateral Pheochromocytoma in Multiple Endocrine Neoplasia Type 2A.: Ji Mi Moon, Yoon Jung Kim, Young Jin Seo, Hye Yoon Choi, Joo Hyong Kim, Ju Ri Park, Yun Jeong Lee, Hee Young Kim, Sin Gon Kim, Dong Seop Choi; J Korean Endocr Soc. 2009;24(4):265-271. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.265

2,456 View
34 Download
4 Crossref

Abstract PDF

Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant syndrome characterized by the presence of medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism. MEN 2A arises due to a germline missense mutation of the RET proto-oncogene. Specific RET mutation analysis has revolutionized the diagnosis and therapy of this disorder, and early thyroidectomy may have lowered the morbidity and mortality associated with these diseases. Ectopic adrenocorticotropic hormone (ACTH) syndrome is characterized by hypercortisolism due to the hypersecretion of ACTH outside of the pituitary gland; the most common causes are malignancies, but rarely adrenal pheochromocytoma may be the cause.

Citations

Citations to this article as recorded by

Pheochromocytoma With High Adrenocorticotropic Hormone Production Capacity Without Pigmentation and Cushingoid Symptoms: A Case Report With a Literature Review
Gen Mizutani, Masashi Isshiki, Eisuke Shimizu, Daigo Saito, Akira Shimada
Cureus.2024;[Epub] CrossRef
Ectopic ACTH- and/or CRH-Producing Pheochromocytomas
Patrick F Elliott, Thomas Berhane, Oskar Ragnarsson, Henrik Falhammar
The Journal of Clinical Endocrinology & Metabolism.2021; 106(2): 598. CrossRef
Severe Cushing Syndrome Due to an ACTH-Producing Pheochromocytoma: A Case Presentation and Review of the Literature
Jenan N Gabi, Maali M Milhem, Yara E Tovar, Emhemmid S Karem, Alaa Y Gabi, Rodhan A Khthir
Journal of the Endocrine Society.2018; 2(7): 621. CrossRef
Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma presented as Cushing syndrome and complicated by invasive aspergillosis
Jae Ho Cho, Da Eun Jeong, Jae Young Lee, Jong Geol Jang, Jun Sung Moon, Mi Jin Kim, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee
Yeungnam University Journal of Medicine.2015; 32(2): 132. CrossRef

A Case of Pneumocystis Carinii Pneumonia and Cutaneous Nocardiosis Associated with Ectopic ACTH Syndrome.: Hee Sun Jung, Seung Hwan Lee, Hee Yeon Kim, Eun Ho Chu, Kang Woo Lee, Mi Ja Kang, Ji Hyun Kim, Hyuk Sang Kwon, Kun Ho Yoon, Bong Yun Cha, Ho Young Son; J Korean Endocr Soc. 2008;23(1):44-50. Published online February 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.1.44

1,951 View
19 Download

Abstract PDF: Cushing's syndrome is characterized by hypercortisolism and impairment of cell-mediated immune function, increasing the risk of opportunistic infection, as occurs in other immunocompromised groups such as organ transplant recipients, patients with lymphoreticular malignancy, or acquired immunodeficiency syndrome. We report a case of a 68-year-old woman who was affected with pneumocystis carinii pneumonia (PCP) 8 years ago and cutaneous nocardiosis this year. The patient was diagnosed with ectopic ACTH syndrome 8 years ago, but no ectopic ACTH secreting focus was found in radiologic imaging studies. She recovered from PCP and cutaneous nocardiosis after antibiotic (trimethoprim-sulfamethoxazole) administration. After the infection resolved, she underwent laparoscopic bilateral adrenalectomy and was not longer hypercortisolemic.

A Case of Ectopic ACTH Syndrome Associated with Small Cell Lung Cancer Presented with Hypokalemia.: Hong Jun Yang, Hea Jung Sung, Ji Eun Kim, Hyo Jin Lee, Jin Min Park, Chan Kwon Park, Eun Suk Roh, Jae Hyung Cho, Seung Hyun Ko, Ki Ho Song, Yu Bai Ahn; J Korean Endocr Soc. 2007;22(5):359-364. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.359

2,331 View
29 Download
4 Crossref

Abstract PDF

We report a case of a 73-year-old female patient who was diagnosed with ectopic ACTH syndrome caused by small cell lung cancer. We initially presumed that the patient was in a state of mineralocorticoid excess, because she had hypertension and hypokalemic alkalosis. This was however excluded because her plasma renin activity was not suppressed and her plasma aldosterone/plasma renin activity ratio was below 25. Moreover, her 24 hour urine free cortisol level was elevated and her serum cortisol levels after a low dose dexamethasone suppression test, were not suppressed. Furthermore, her basal plasma ACTH and serum cortisol levels increased and her serum cortisol level after a high dose dexamethasone suppression test was not suppressed. We performed studies to identify the source of ectopic ACTH syndrome and found a 3 cm-sized mass in the patient's right lower lobe of her lung, which was eventually diagnosed as small cell lung cancer following a bronchoscopic biopsy. In conclusion, Cushing's syndrome, and in particular ectopic ACTH syndrome, must be considered in the differential diagnosis of mineralocorticoid-induced hypertension. The excessive cortisol saturates the 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) activity, which in turn, inactivates the conversion of cortisol to cortisone in the renal tubules. Moreover, excessive cortisol causes binding to the mineralocorticoid receptors, causing mineralocorticoid hypertension, characterized by severe hypercortisolism.

Citations

Citations to this article as recorded by

Emergencia hipertensiva como debut de síndrome de Cushing paraneoplásico
E. Rubio González, M. de Valdenebro Recio, M.I. Galán Fernández
Hipertensión y Riesgo Vascular.2024; 41(2): 135. CrossRef
Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review
Yanlong Li, Caiyu Li, Xiangjun Qi, Ling Yu, Lizhu Lin
Frontiers in Endocrinology.2023;[Epub] CrossRef
Ectopic Cushing Syndrome in Adenocarcinoma of the Lung: Case Report and Literature Review
Rana Al-Zakhari, Safa Aljammali, Basma Ataallah, Svetoslav Bardarov, Philip Otterbeck
Cureus.2021;[Epub] CrossRef
A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer
Chaiho Jeong, Jinhee Lee, Seongyul Ryu, Hwa Young Lee, Ah Young Shin, Ju Sang Kim, Joong Hyun Ahn, Hye Seon Kang
Tuberculosis and Respiratory Diseases.2015; 78(4): 436. CrossRef

A Case of Silent Corticotroph-cell Adenoma with Elevated Serum ACTH.: Jeong Geun Moon, So Young Park, Byoung Chul Cho, Jung Min Lee, Si Hoon Lee, Yoo Mee Kim, Yu Mie Rhee, Bong Soo Cha, Hyun Chul Lee, Sung Kil Lim; J Korean Endocr Soc. 2004;19(5):535-541. Published online October 1, 2004

1,097 View
16 Download

Abstract PDF: A 48 year-old man was referred to our Department with a headache, and also presented with an elevated serum ACTH level, but without an elevated serum cortisol. Although there was no clinical evidence of Cushing's syndrome, a brain CT and MRI showed a 4x4.5 cm sized pituitary mass, which was successfully removed by a transsphenoidal approach (TSA). A histopathological examination revealed the mass to have an ACTH positive reaction. Therefore, through hormonal and pathological evaluation, a silent corticotroph-cell adenoma (SCCA), with an elevated serum ACTH level, was diagnosed. Although reports on SCCA have been recently increased, this case is reported because these kinds of tumor are still rare, and those SCCA with an elevated serum ACTH even more so

Original Article

Diagnostic Value of 1microgram Rapid ACTH Stimulation Test According to the Timing of Sampling of Serum Cortisol in Patients with Suspected Central Adrenal Insufficiency.: Sang Wan Kim, Young Min Cho, Do Joon Park, Chan Soo Shin, Kyung Soo Park, Seong Yeon Kim, Bo Youn Cho, Hong Kyu Lee; J Korean Endocr Soc. 2004;19(1):33-41. Published online February 1, 2004

1,398 View
20 Download

Abstract PDF: BACKGROUND
Traditional testing of the hypothalamic-pituitary-adrenal axis function has essentially relied upon the insulin tolerance test or the metyrapone test(both tests are not only uncomfortable, but are also dangerous). The standard ACTH stimulation test uses an extremely supra-physiologic amount(250f microgram) of ACTH to evaluate a physiological response, which may result in a false normal response. The 1microgram rapid ACTH stimulation test is more physiological and more sensitive than the standard test, but there exist much controversy about when the serum cortisol should be measured or what the most appropriate cut-off point is for normality or whether the 1microgram ACTH commercial solution is needed. The aims of this study were to investigate 1) whether 1microgram of ACTH is an appropriate amount to stimulate the adrenal gland of patients that have suspected central adrenal insufficiency compared with insulin tolerance test(ITT) and 2) the diagnostic value of the 1microgram rapid ACTH stimulation test according to timing of sampling of serum cortisol. METHODS: In order to evaluate the dose-response relationship between ACTH and cortisol, we performed the ITT in 77 patients with suspected central adrenal insufficiency with serial measurements of serum cortisol and plasma ACTH. We drew the blood samples in 10 min intervals between 10 and 60 min after the administration of 1microgram ACTH in 39 patients with central adrenal insufficiency and in 38 pituitary control patients with pituitary. ITT was used to confirm the diseases for the patients of central adrenal insufficiency, but for pituitary control patients, the ITT indicated normality in the patients. Also, all subjects underwent the 250microgram rapid ACTH stimulation test, and we compared the diagnostic value of the 1microgram ACTH stimulation test with the 250microgram test. RESULTS: 1) The plasma ACTH level after the 1microgram ACTH stimulation test, even if it was be assumed as approximately 300pg/mL, was expected to be sufficient enough to stimulate the adrenal cortex normally(serum cortisol levels >18microgram/dL) compared to the plasma ACTH level in the ITT. 2) The sensitivity and specificity of the 1microgram rapid ACTH stimulation test was highest with 92.3% and 84.2%, respectively, when serum cortisol levels were measured at 20, 30, and 40 min after the ACTH injection. The 1microgram rapid ACTH stimulation test was more sensitive than the 250microgram ACTH test(sensitivity: 92.3%, specificity: 71.8%). CONCLUSION: The 1microgram rapid ACTH stimulation test was more sensitive test in patients with suspected central adrenal insufficiency, and blood samples for cortisol levels should be drawn at 20, 30, and 40 min after ACTH administration.

Case Report

A Case of AVP Dependent Bilateral Macronodular Adrenal Hyperplasia.: Hyun Jin Kim, Se Hwa Kim, Yu Mie Rhee, Sung Eun Kim, Chul Woo Ahn, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Sung Kil Lim; J Korean Endocr Soc. 2002;17(4):603-609. Published online August 1, 2002

1,204 View
19 Download

Abstract PDF: Adrenocorticotropin (ACTH) independent bilateral macronodular adrenal hyperplasia (AIMAH) is a rare form of Cushing's syndrome, in which unique endocrinological, clinical and histopathological features have been described. In AIMAH, cortisol secretion is autonomous and independent of ACTH, thus plasma ACTH levels are persistently suppressed. Various etiological mechanisms have been proposed to explain the development of AIMAH, the development of aberrant adrenal sensitivity to gastric inhibitory polypeptide (GIP), vasopressin, beta-adrenergic receptor agonists or the presence of circulating adrenal stimulating immunoglobulins have been suggested. We report on a 46-year-old female who had Cushing's syndrome, due to AIMAH, with a positive response to vasopressin.

First
Prev
Page of 2
Next
Last

Search