Endocrinology and Metabolism

Review Article

Hypothalamus and pituitary gland
New Sparks and Spots: Molecular Imaging with Positron Emission Tomography Will Change Management of Cushing’s Disease: Martin Reincke, Tugce Apaydin, Mariam Kakashvili, Nathalie L. Albert, Jun Thorsteinsdottir, Júnia R. O. L. Schweizer, Marily Theodoropoulou, Katharina Schilbach, Friederike Völter; Endocrinol Metab. 2026;41(1):49-56. Published online February 3, 2026; DOI: https://doi.org/10.3803/EnM.2025.2728

2,610 View
97 Download
1 Web of Science
1 Crossref

Cushing’s disease is caused by corticotroph tumors of the pituitary gland, resulting in adrenocorticotropic hormone hypersecretion and cortisol excess. The majority of the tumors are microadenomas. Magnetic resonance imaging (MRI) imaging is able to detect up to 70% of the corticotroph tumors. In the remaining patients, no tumor is detectable on MRI or there are equivocal changes without a clear demarcation of a tumor. Hence, the cure rates following transsphenoidal pituitary surgery are far from being satisfactory, with around 60% to 90% short-term remission in expert centers. Positron emission tomography (PET) has recently emerged as a potent method for the localization of small corticotroph adenomas and corticotroph adenomas without demarcation on the MRI. This review analyzes the radiopharmaceuticals most commonly used in evaluating pituitary disorders and explores the potential utilization of new PET tracers for personalized management of patients with Cushing’s disease. Especially ¹¹C-methionine and ¹⁸F-fluorethyltyrosine PET have recently been reported to be highly sensitive methods to detect MRI-undetectable corticotropinomas in 80% to 100% of patients. If confirmed in randomized controlled trials, PET imaging could be a major break-through towards targeted, individualized surgical therapy.

Citations

Citations to this article as recorded by

Functional pituitary adenoma imaging
Linus Hesse, Linus Haberbosch
Reviews in Endocrine and Metabolic Disorders.2026;[Epub] CrossRef

Original Articles

Diabetes, obesity and metabolism
Distinct Pituitary-Adrenal Responses to Hypoglycemia in Type 1 and Type 2 Diabetes: Yun Hu, Reng-na Yan, Ting-ting Cai, Xiao-wei Zhu, Jian-hua Ma, Bo Ding; Endocrinol Metab. 2026;41(1):162-173. Published online December 3, 2025; DOI: https://doi.org/10.3803/EnM.2025.2479

2,638 View
74 Download

Abstract PDF Supplementary Material PubReader ePub: Background
Hypoglycemia remains a major barrier to optimal glycemic control in diabetes. Counter-regulatory hormonal responses, particularly those involving the pituitary and adrenal systems, play a central role in mitigating hypoglycemia, yet differences between diabetes subtypes are not well characterized. We aimed to investigate pituitary-target gland responses to hypoglycemia in patients with type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM).
Methods
We enrolled drug-naive patients with newly diagnosed T2DM or T1DM, along with controls who did not have diabetes. Participants with diabetes received insulin pump therapy until normoglycemia was achieved. Hyperinsulinemic euglycemic-hypoglycemic clamps were then performed in all participants. Hormonal profiles of the pituitary-adrenal axis and C-peptide were serially measured during the clamps.
Results
During hypoglycemic clamps, C-peptide, thyroid-stimulating hormone, estradiol, and testosterone decreased, whereas prolactin, adrenocorticotropic hormone (ACTH), cortisol, and growth hormone (GH) increased significantly according to repeatedmeasures analysis of variance (ANOVA) (P<0.05 for all). Compared to controls and T2DM, patients with T1DM exhibited elevated basal GH (P=0.002) and an exaggerated GH response to hypoglycemia (P=0.002), with earlier onset and sustained elevation. In contrast, patients with T2DM showed higher ACTH (P=0.024) and cortisol (P=0.043) levels during hypoglycemia compared to controls and T1DM. Relative to the T1DM group, the T2DM group demonstrated lower testosterone and higher estradiol levels during hypoglycemia (P<0.001 for both).
Conclusion
Distinct diabetes subtypes demonstrate divergent pituitary-adrenal counter-regulatory responses to hypoglycemia, suggesting unique pathogenic mechanisms contributing to glycemic variability. The exaggerated GH response in T1DM may aggravate glucose fluctuations, whereas elevated ACTH and cortisol in T2DM could perpetuate insulin resistance.

Hypothalamus and pituitary gland
⁶⁸Ga-DOTATOC PET/CT in the Localization of Pituitary Tumors in Cushing’s Disease: Kyungwon Kim, Dongwoo Kim, Min-Ho Lee, Yae Won Park, Sung Soo Ahn, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Cheol Ryong Ku, Eun Jig Lee; Endocrinol Metab. 2025;40(4):637-647. Published online March 18, 2025; DOI: https://doi.org/10.3803/EnM.2024.2249

5,907 View
156 Download
8 Web of Science
9 Crossref

Abstract PDF PubReader ePub

Background
This study aimed to determine the value of ⁶⁸Ga-DOTATOC positron emission tomography/computed tomography (PET/CT) in localizing adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas.
Methods
In this retrospective cohort study, we enrolled 30 patients with Cushing’s disease and positive ACTH immunoreactivity. All patients underwent ⁶⁸Ga-DOTATOC PET/CT and pituitary magnetic resonance imaging (MRI) before transsphenoidal adenomectomy.
Results
Twenty-five patients showed ⁶⁸Ga-DOTATOC uptake in their pituitary glands on PET/CT. Median age, pre-operative ACTH levels, pre-operative cortisol, and tumor size on MRI were comparable irrespective of DOTATOC uptake. ⁶⁸Ga-DOTATOC PET/CT showed a 77% success rate for localizing adenomas, which was not statistically different from that of MRI. The ACTH level in the successful localization group was significantly higher than that in the failed group (84.41 pg/mL vs. 37.26 pg/mL, P=0.001). The ACTH level was statistically significant predictor of successful localization using ⁶⁸Ga-DOTATOC PET/CT (P=0.013). The area under the curve was 0.932 with a cutoff of 53.86 pg/mL for ACTH levels to determine successful localization. Pre-operative ACTH levels above 53.86 pg/mL showed the best diagnostic accuracy in predicting the success of localizing adenomas (sensitivity, 91.3%; specificity, 85.7%). Mean and maximum standardized uptake value of adenoma negatively correlated to pre-operative ACTH level.
Conclusion
Plasma ACTH level is a favorable predictor for the successful localization and negative correlation with ⁶⁸Ga-DOTATOC uptake of corticotroph adenomas in ⁶⁸Ga-DOTATOC PET/CT. ⁶⁸Ga-DOTATOC PET/CT did not improve tumor localization for Cushing’s disease compared with MRI alone.

Citations

Citations to this article as recorded by

[68Ga]Ga-DOTATATE PET/CT and PET/MR enhances the detection of pituitary ACTH-secreting adenomas in cushing’s disease
Zizhen Zhang, Si Xu, Xiaochen Li, Yang Liu, Chang Liu, Jinxin Zhou, Yifan Zhang
Frontiers in Endocrinology.2026;[Epub] CrossRef
New Sparks and Spots: Molecular Imaging with Positron Emission Tomography Will Change Management of Cushing’s Disease
Martin Reincke, Tugce Apaydin, Mariam Kakashvili, Nathalie L. Albert, Jun Thorsteinsdottir, Júnia R. O. L. Schweizer, Marily Theodoropoulou, Katharina Schilbach, Friederike Völter
Endocrinology and Metabolism.2026; 41(1): 49. CrossRef
A pilot study of [68Ga]Ga-DOTA-TATE PET-based radiation contouring for pituitary adenoma
Bradley Eckelmann, Takwa Salem, April Premo, Kaili Ranta, Colin Harari, Benjamin Durkee, Matthew Larson, Azam Ahmed, Ali Pirasteh, Michael C. Veronesi, Brett Morris
Clinical and Translational Radiation Oncology.2026; 59: 101178. CrossRef
Molecular imaging in pituitary neuroendocrine tumors: a narrative review of advances, challenges, and future perspectives
Romy van der Groef, Ilanah Pruis, Amber Audhoe, Julie Refardt, Sophie Veldhuijzen van Zanten, Sebastian Neggers
European Journal of Endocrinology.2026; 194(5): R83. CrossRef
Functional pituitary adenoma imaging
Linus Hesse, Linus Haberbosch
Reviews in Endocrine and Metabolic Disorders.2026;[Epub] CrossRef
A multicenter-validated interpretable transformer model for pituitary microadenoma detection on non-contrast multiparametric MRI
Siru Kang, Wenxia Yang, Yijun Yu, Kai Wang, Wenhuan Yuan, Yanli Jiang, Jing Zhang
BMC Medical Imaging.2026;[Epub] CrossRef
A stacking model for AI-assisted diagnosis of suspected pituitary microadenomas on non-contrast T1COR MRI: a multicenter reader study on bridging the experience gap
Siru Kang, Kai Wang, Yijun Yu, Wenxia Yang, Wenhuan Yuan, Yanli Jiang, Jing Zhang
Neuroradiology.2026;[Epub] CrossRef
Novel Imaging Modalities in the Evaluation of Patients with Pituitary Adenomas
Kevin A. Huynh, James MacFarlane, Waiel A. Bashari, Daniel Gillett, Mark Gurnell
Endocrinology and Metabolism Clinics of North America.2025; 54(4): 549. CrossRef
Research Progress on the Transformation Mechanism of Silent Adrenocorticotropic Hormone Cell Adenoma and Cushing’s Disease
思凡鄢
Advances in Clinical Medicine.2025; 15(11): 93. CrossRef

Hypothalamus and pituitary gland
Combined PD-1 and CTLA-4 Blockade Increases the Risks of Multiple Pituitary Hormone Deficiency and Isolated Adrenocorticotropic Deficiency: A Prospective Study: Shintaro Iwama, Tomoko Kobayashi, Tetsushi Izuchi, Koji Suzuki, Takanori Murase, Masahiko Ando, Tomoko Handa, Takeshi Onoue, Takashi Miyata, Mariko Sugiyama, Daisuke Hagiwara, Hidetaka Suga, Ryoichi Banno, Tetsunari Hase, Shoichiro Mori, Tomoyasu Sano, Shusuke Akamatsu, Masashi Akiyama, Makoto Ishii, Hiroshi Arima; Endocrinol Metab. 2025;40(3):459-468. Published online February 11, 2025; DOI: https://doi.org/10.3803/EnM.2024.2180

5,904 View
114 Download
4 Web of Science
5 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Anti-cytotoxic T-lymphocyte antigen-4 antibody (CTLA-4-Ab) monotherapy induces two types of pituitary immunerelated adverse events (irAEs): multiple pituitary hormone deficiency (Multi-D; impairment of ≥2 anterior pituitary hormones) and isolated adrenocorticotropic hormone (ACTH) deficiency (IAD). Combination therapy with CTLA-4-Ab and anti-programmed cell death-1 antibody (PD-1/CTLA-4-Abs), which is increasingly replacing CTLA-4-Ab monotherapy, frequently causes pituitary irAEs; however, whether it increases Multi-D/IAD incidence is unknown.
Methods
In total, 74 and 748 patients with malignancies treated with PD-1/CTLA-4-Abs and PD-1-Ab, respectively, were prospectively evaluated for ACTH and cortisol levels at baseline and every 6 weeks after treatment initiation, and then observed until the last clinical visit. The characteristics of pituitary irAEs were evaluated by pituitary stimulation tests and compared with those induced by PD-1-Ab monotherapy.
Results
PD-1/CTLA-4-Abs therapy showed higher incidence rates of pituitary irAEs (16/74 [21.6%] vs. 25/748 [3.3%], P<0.001), Multi-D (9/74 [12.2%] vs. 2/748 [0.3%], P<0.001), and IAD (7/74 [9.5%] vs. 23/748 [3.1%], P=0.014) than PD-1-Ab monotherapy. ACTH deficiency was observed in all cases, whereas the prevalence rates of luteinizing hormone deficiency (8/16 [50.0%] vs. 1/25 [4.0%]), follicle-stimulating hormone deficiency (6/16 [37.5%] vs. 1/25 [4.0%]), and thyrotropin deficiency (4/16 [25.0%] vs. 0/25 [0%]) were significantly higher after PD-1/CTLA-4-Abs than after PD-1-Ab treatment. Pituitary enlargement, which was observed only in the Multi-D cases, was significantly more frequent after PD-1/CTLA-4-Abs than after PD-1-Ab treatment (6/16 [37.5%] vs. 0/25 [0%], P=0.002).
Conclusion
This prospective study revealed high risks of both Multi-D and IAD under PD-1/CTLA-4-Abs treatment, emphasizing the need for careful evaluation of pituitary function.

Citations

Citations to this article as recorded by

Concurrent Pituitary and Thyroid Immune-Related Adverse Events after Immune Checkpoint Inhibitors Associated with HLA-DR15–Related Haplotypes
Tomoko Kobayashi, Shintaro Iwama, Eri Sugiyama, Shohei Koyama, Tetsushi Izuchi, Koji Suzuki, Takanori Murase, Masahiko Ando, Hidefumi Inaba, Hiroki Izumi, Koichi Goto, Tomoko Handa, Takeshi Onoue, Takashi Miyata, Mariko Sugiyama, Daisuke Hagiwara, Hidetak
Cancer Immunology Research.2026; 14(4): 599. CrossRef
Immune-Mediated Hypophysitis: An Updated Review
Pedro Iglesias
Journal of Clinical Medicine.2026; 15(9): 3313. CrossRef
Dominant T cell receptor clonotypes in adrenocorticotropic hormone-secreting pituitary carcinoma are the highest-frequency clones among CD4+ and CD8+ cells in peripheral blood during effective anti-PD-1 therapy
Mariko Sugiyama, Shintaro Iwama, Kazuhito Takeuchi, Tomoko Kobayashi, Takanori Murase, Daisuke Hagiwara, Hao Chen, Yuichi Nagata, Ryuta Saito, Yoshiki Akatsuka, Hiroshi Arima
Frontiers in Immunology.2026;[Epub] CrossRef
Immune Checkpoint Inhibitor-Related Hypophysitis: A Call for Vigilance
Ju Hee Lee
Endocrinology and Metabolism.2025; 40(3): 391. CrossRef
Immune Checkpoint Inhibitor-Related Hypophysitis and Pituitary Dysfunction: A Systematic Review of Diagnosis and Management
Pooja SirDeshpande, Soorya Bavikeri Shivakumara Hegde, Hassan Akhtar
Cureus.2025;[Epub] CrossRef

Review Articles

Hypothalamus and Pituitary Gland
Independent Skeletal Actions of Pituitary Hormones: Se-Min Kim, Farhath Sultana, Funda Korkmaz, Daria Lizneva, Tony Yuen, Mone Zaidi; Endocrinol Metab. 2022;37(5):719-731. Published online September 28, 2022; DOI: https://doi.org/10.3803/EnM.2022.1573

11,635 View
287 Download
13 Web of Science
12 Crossref

Abstract PDF PubReader ePub

Over the past years, pituitary hormones and their receptors have been shown to have non-traditional actions that allow them to bypass the hypothalamus-pituitary-effector glands axis. Bone cells—osteoblasts and osteoclasts—express receptors for growth hormone, follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), prolactin, oxytocin, and vasopressin. Independent skeletal actions of pituitary hormones on bone have been studied using genetically modified mice with haploinsufficiency and by activating or inactivating the receptors pharmacologically, without altering systemic effector hormone levels. On another front, the discovery of a TSH variant (TSH-βv) in immune cells in the bone marrow and skeletal action of FSHβ through tumor necrosis factor α provides new insights underscoring the integrated physiology of bone-immune-endocrine axis. Here we discuss the interaction of each pituitary hormone with bone and the potential it holds in understanding bone physiology and as a therapeutic target.

Citations

Citations to this article as recorded by

Deciphering inter-organ communication: The multi-organ-bone axis in osteoporosis and emerging therapeutic strategies
Ruiming Wen, Haixia Wang, Songtao Wang
Journal of Orthopaedic Translation.2026; 58: 101119. CrossRef
The influence of hormonal changes during pregnancy on bone metabolism - a mini review
Anna Brona, Barbara Stachowska, Marek Bolanowski, Jowita Halupczok-Żyła
Frontiers in Endocrinology.2026;[Epub] CrossRef
Plasma proteomic profiles reveal proteins and three characteristic patterns associated with osteoporosis: A prospective cohort study
Yi Zheng, Jincheng Li, Yucan Li, Jiacheng Wang, Chen Suo, Yanfeng Jiang, Li Jin, Kelin Xu, Xingdong Chen
Journal of Advanced Research.2025; 75: 491. CrossRef
Fracture risks in patients aged 50 years and older with panhypopituitarism: a nationwide cohort study
Seung Shin Park, Hyunmook Jeong, Chang Ho Ahn, Min Jeong Park, Sung Hye Kong, Sang Wan Kim, Chan Soo Shin, Yong Hwy Kim, Kwangsoo Kim, Jung Hee Kim
Osteoporosis International.2025; 36(10): 1951. CrossRef
Cushing’s disease and bone
Aleksandra Zdrojowy-Wełna, Barbara Stachowska, Marek Bolanowski
Pituitary.2024; 27(6): 837. CrossRef
Skeletal fragility in pituitary disease: how can we predict fracture risk?
Fabio Bioletto, Alessandro Maria Berton, Marco Barale, Luigi Simone Aversa, Lorenzo Sauro, Michela Presti, Francesca Mocellini, Noemi Sagone, Ezio Ghigo, Massimo Procopio, Silvia Grottoli
Pituitary.2024; 27(6): 789. CrossRef
Role of oxytocin in bone
Tianming Wang, Jianya Ye, Yongqiang Zhang, Jiayi Li, Tianxiao Yang, Yufeng Wang, Xiao Jiang, Qingqiang Yao
Frontiers in Endocrinology.2024;[Epub] CrossRef
Modern approach to bone comorbidity in prolactinoma
Meliha Melin Uygur, Sara Menotti, Simona Santoro, Andrea Giustina
Pituitary.2024; 27(6): 802. CrossRef
New tools for bone health assessment in secreting pituitary adenomas
Meliha Melin Uygur, Stefano Frara, Luigi di Filippo, Andrea Giustina
Trends in Endocrinology & Metabolism.2023; 34(4): 231. CrossRef
A Causality between Thyroid Function and Bone Mineral Density in Childhood: Abnormal Thyrotropin May Be Another Pediatric Predictor of Bone Fragility
Dongjin Lee, Moon Ahn
Metabolites.2023; 13(3): 372. CrossRef
The mechanism of oxytocin and its receptors in regulating cells in bone metabolism
Liu Feixiang, Feng Yanchen, Li Xiang, Zhang Yunke, Miao Jinxin, Wang Jianru, Lin Zixuan
Frontiers in Pharmacology.2023;[Epub] CrossRef
To investigate the mechanism of Yiwei Decoction in the treatment of premature ovarian insufficiency-related osteoporosis using transcriptomics, network pharmacology and molecular docking techniques
Weisen Fan, Yan Meng, Jing Zhang, Muzhen Li, Yingjie Zhang, Xintian Qu, Xin Xiu
Scientific Reports.2023;[Epub] CrossRef

Adrenal Gland
Adrenal Venous Sampling for Subtype Diagnosis of Primary Hyperaldosteronism: Mitsuhide Naruse, Akiyo Tanabe, Koichi Yamamoto, Hiromi Rakugi, Mitsuhiro Kometani, Takashi Yoneda, Hiroki Kobayashi, Masanori Abe, Youichi Ohno, Nobuya Inagaki, Shoichiro Izawa, Masakatsu Sone; Endocrinol Metab. 2021;36(5):965-973. Published online October 21, 2021; DOI: https://doi.org/10.3803/EnM.2021.1192

21,503 View
441 Download
15 Web of Science
17 Crossref

Abstract PDF PubReader ePub

Adrenal venous sampling (AVS) is the key procedure for lateralization of primary hyperaldosteronism (PA) before surgery. Identification of the adrenal veins using computed tomography (CT) and intraoperative cortisol assay facilitates the success of catheterization. Although administration of adrenocorticotropic hormone (ACTH) has benefits such as improving the success rate, some unilateral cases could be falsely diagnosed as bilateral. Selectivity index of 5 with ACTH stimulation to assess the selectivity of catheterization and lateralization index (LI) >4 with ACTH stimulation for unilateral diagnosis is used in many centers. Co-secretion of cortisol from the tumor potentially affects the lateralization by the LI. Patients aged <35 years with hypokalemia, marked aldosterone excess, and unilateral adrenal nodule on CT have a higher probability of unilateral disease. Patients with normokalemia, mild aldosterone excess, and no adrenal tumor on CT have a higher probability of bilateral disease. Although no methods have 100% specificity for subtype diagnosis that would allow bypassing AVS, prediction of the subtype should be considered when recommending AVS to patients. Methodological standardization and strict indication improve diagnostic quality of AVS. Development of non-invasive imaging and biochemical markers will drive a paradigm shift in the clinical practice of PA.

Citations

Citations to this article as recorded by

Adrenal Venous Sampling Aids in Distinguishing 17-Hydroxyprogesterone Hypersecreting Adrenal Cortical Adenomas from Non-Classical 21-Hydroxylase Deficiency
Ruojun Qiu, Tian Yang, Chengxin Shang, Weifen Zhu, Fenping Zheng
Diagnostics.2026; 16(2): 202. CrossRef
Ablation for Aldosterone-Producing versus Cortisol-Producing Adrenal Adenomas: A Comprehensive Review
Byung Kwan Park, Jae Hyeon Kim, Young Lyun Oh, Jung-Han Kim
Journal of Vascular and Interventional Radiology.2026; 37(9): 108894. CrossRef
Manejo quirúrgico del hiperaldosteronismo primario: un caso de suprarrenalectomía laparoscópica en una paciente joven
Hugo Javier Benítez Rios, Iván Alberto Núñez Guerrero, Sol Thalía Silvero Prieto, Daniel Fernández González
Revista científica ciencias de la salud..2026; 8: 01. CrossRef
Bilateral adrenal artery embolization for the treatment of idiopathic hyperaldosteronism: A proof-of-principle single center study
Guo Ji, Changqiang Yang, Jixin Hou, Yaqiong Zhou, Tao Luo, Yi Yang, Dan Wang, Sen Liu, Jindong Wan, Gaomin He, Anping Zeng, Xinquan Wang, Peijian Wang
Hypertension Research.2025; 48(1): 200. CrossRef
Adrenal vein sampling: accuracy of earlier sampling post adrenocorticotropic hormone (ACTH) administration
Q.X. Tee, J.C.G. Doery, A. Desra, P.J. Fuller, J. Yang, K.K. Lau
Clinical Radiology.2025; 84: 106861. CrossRef
Long-term Efficacy and Safety of Unilateral Adrenal Artery Embolization in Patients with Idiopathic Hyperaldosteronism: A 24-month Cohort Study
Guo Ji, Sen Liu, Jindong Wan, Yaqiong Zhou, Changqiang Yang, Xinquan Wang, Gaomin He, Anping Zeng, Lingling Zhang, Tao Luo, Yi Yang, Dan Wang, Kaige Feng, Jixin Hou, Peijian Wang
American Journal of Hypertension.2025; 38(9): 675. CrossRef
Expert Consensus on the Primary Aldosteronism Severity Classification and its strategic application in indicating adrenal venous sampling
Masanori Murakami, Mitsuhide Naruse, Hiroki Kobayashi, Mirko Parasiliti-Caprino, Fabio Bioletto, Denise Brüdgam, Isabel Stüfchen, Martin Reincke, Matthieu St-Jean, Ivana Kraljevic, Darko Kastelan, Pasi I Nevalainen, Marta Araujo-Castro, Norlela Sukor, Mic
European Journal of Endocrinology.2025; 193(1): 85. CrossRef
A controlled trial of percutaneous adrenal arterial embolization for hypertension in patients with idiopathic hyperaldosteronism
Yaqiong Zhou, Xinquan Wang, Jixin Hou, Jindong Wan, Yi Yang, Sen Liu, Tao Luo, Qiting Liu, Qiang Xue, Peijian Wang
Hypertension Research.2024; 47(2): 311. CrossRef
Correlation of Histopathologic Subtypes of Primary Aldosteronism with Clinical Phenotypes and Postsurgical Outcomes
Chang Ho Ahn, You-Bin Lee, Jae Hyeon Kim, Young Lyun Oh, Jung Hee Kim, Kyeong Cheon Jung
The Journal of Clinical Endocrinology & Metabolism.2024; 109(8): e1582. CrossRef
Screening and diagnosis of primary aldosteronism. Consensus document of all the Spanish Societies involved in the management of primary aldosteronism
Marta Araujo-Castro, Jorge Gabriel Ruiz-Sánchez, Paola Parra Ramírez, Patricia Martín Rojas-Marcos, Almudena Aguilera-Saborido, Jorge Francisco Gómez Cerezo, Nieves López Lazareno, María Eugenia Torregrosa Quesada, Jorge Gorrin Ramos, Josep Oriola, Esteba
Endocrine.2024; 85(1): 99. CrossRef
Temporal trends in clinical features of patients with primary aldosteronism over 20 years
Seung Shin Park, Chang Ho Ahn, Sang Wan Kim, Jung-Min Koh, Seung Hun Lee, Jung Hee Kim
Hypertension Research.2024; 47(8): 2019. CrossRef
Primary aldosteronism: An underdiagnosed clinical entity
Peeyush Jain, Atul Kaushik, Nilashish Dey, Ashwani Mehta, Shaloo Kapoor, Chhavi Agrawal
Journal of Current Cardiology.2024; 2(2): 65. CrossRef
Diagnostic accuracy of using multiple cytokines to predict aldosterone-producing adenoma
Fei Qin, Hong Wen, Xiaoge Zhong, Yajin Pan, Xiaomei Lai, Tingting Yang, Jing Huang, Jie Yu, Jianling Li
Scientific Reports.2023;[Epub] CrossRef
A clinical assessment of portable point-of-care testing for quick cortisol assay during adrenal vein sampling
Ko Aiga, Mitsuhiro Kometani, Shigehiro Karashima, Seigo Konishi, Takuya Higashitani, Daisuke Aono, Xurong Mai, Mikiya Usukura, Takahiro Asano, Ayako Wakayama, Yuko Noda, Wataru Koda, Tetsuya Minami, Satoshi Kobayashi, Toshinori Murayama, Takashi Yoneda
Scientific Reports.2023;[Epub] CrossRef
2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism
Jeonghoon Ha, Jung Hwan Park, Kyoung Jin Kim, Jung Hee Kim, Kyong Yeun Jung, Jeongmin Lee, Jong Han Choi, Seung Hun Lee, Namki Hong, Jung Soo Lim, Byung Kwan Park, Jung-Han Kim, Kyeong Cheon Jung, Jooyoung Cho, Mi-kyung Kim, Choon Hee Chung
Endocrinology and Metabolism.2023; 38(6): 597. CrossRef
Adrenal Venous Sampling in Primary Aldosteronism: Single-Centre Experience from Western India
Krantikumar Rathod, Saba S. Memon, Punit Mahajan, Anurag Lila, Dhaval Thakkar, Hemant Deshmukh, Tushar Bandgar
Indian Journal of Endocrinology and Metabolism.2023; 27(1): 80. CrossRef
The Entity of Connshing Syndrome: Primary Aldosteronism with Autonomous Cortisol Secretion
Mara Carsote
Diagnostics.2022; 12(11): 2772. CrossRef

Adrenal gland
Recent Updates on the Diagnosis and Management of Cushing's Syndrome: Lynnette K. Nieman; Endocrinol Metab. 2018;33(2):139-146. Published online June 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.2.139

34,708 View
1,290 Download
63 Web of Science
62 Crossref

Abstract PDF PubReader ePub

Cushing's syndrome, a potentially lethal disorder characterized by endogenous hypercortisolism, may be difficult to recognize, especially when it is mild and the presenting features are common in the general population. However, there is a need to identify the condition at an early stage, as it tends to progress, accruing additional morbidity and increasing mortality rates. Once a clinical suspicion is raised, screening tests involve timed measurement of urine, serum or salivary cortisol at baseline or after administration of dexamethasone, 1 mg. Each test has caveats, so that the choice of tests must be individualized for each patient. Once the diagnosis is established, and the cause is determined, surgical resection of abnormal tumor/tissue is the optimal treatment. When this cannot be achieved, medical treatment (or bilateral adrenalectomy) must be used to normalize cortisol production. Recent updates in screening for and treating Cushing's syndrome are reviewed here.

Citations

Citations to this article as recorded by

Iatrogenic Cushing’s Syndrome and the Hidden Ingredient of Artri King
Basma Ataallah, Mohammed Al Tameemi
Cureus.2026;[Epub] CrossRef
Successful Use of Continuous Etomidate Intravenous Infusion for Treatment of Ectopic Cushing Syndrome due to Small Cell Lung Carcinoma With Perforated Sigmoid Diverticulitis
Aizaaz Ahmad Faiz, Muhammad Bilal Shahid, Joseph Norman, Angela Montalvo, Tipu Faiz Muhammad Saleem
AACE Endocrinology and Diabetes.2026; 13(4): 622. CrossRef
The roles, mechanisms, and therapeutic implications of glucocorticoids in glucose and lipid metabolism
Qiu-Yu Xu, Jie Zhang, Xin-Jian Wan, Ling Wu, Ji-Chun Yang, Yan Lu
Military Medical Research.2026; 13(1): 100037. CrossRef
Adrenocorticotropic hormone-independent Cushing syndrome
PRAKRITI SANJAY RAMAMURTHY, U.K. POOJA, THANISHA SANTHOSH, Y.P. GANAVI
The National Medical Journal of India.2026; 0: 1. CrossRef
11-deoxycortisol, other hormones and pituitary function characteristics in the diagnosis of adrenal insufficiency in the overnight oral metyrapone test
Alexander Krawzow, Mirko Peitzsch, Manuela Bastian, Till Postrach, Lisa Johanna Harms, Elena Novikova, Graeme Eisenhofer, Holger S Willenberg
Endocrine Connections.2026;[Epub] CrossRef
Adverse Cardiovascular Risk Profile and Increased Diurnal Salivary Cortisol in Girls With Turner Syndrome: An Exploratory Study
Lily Jones, Julie Park, Silothabo Dliso, Daniel B. Hawcutt, Alena Shantsila, Gregory Y. H. Lip, Joanne Blair
American Journal of Medical Genetics Part C: Seminars in Medical Genetics.2025; 199(2): 116. CrossRef
Matching-Adjusted Indirect Comparison of Osilodrostat Versus Metyrapone for the Treatment of Cushing’s Syndrome
Conor Hickey, Beatrice Gueron, Fabian Schmidt, Emma Tyas, Grzegorz Binowski, Rosario Pivonello
Advances in Therapy.2025; 42(7): 3472. CrossRef
Ectopic Cushing Syndrome due to Metastatic Medullary Thyroid Cancer
Majd Oweidat, Anas Abu Rumilah
AACE Endocrinology and Diabetes.2025; 12(1): 19. CrossRef
Diurnal rhythm of the human plasma proteome
Elvar M. S. Jóhönnuson, Henriette P. Sennels, Henrik L. Jørgensen, Jens Hannibal, Ching-Yan Chloé Yeung, Christine Rasmussen, Gabriela Zofia Prus, Nicolai J. Wewer Albrechtsen, Annelaura Bach Nielsen
Clinical Proteomics.2025;[Epub] CrossRef
Knowledge mapping of Cushing syndrome: A bibliometric analysis from 2000 to 2023
Xiao Lu, Mingyu Huang, Yufang Yang, Dongxiao Chen, Fuli Qin, Quanyuan Huang
Medicine.2025; 104(47): e46025. CrossRef
Steroid as a Saviour and Culprit in Pemphigus Vulgaris Therapy: A Rare Case Series
Deepthi Avvaru, Raushan Kumar Chaudhary, Bhavana Doshi, Ramesh Bhandari
Current Drug Therapy.2024; 19(3): 360. CrossRef
Exploring alternative treatment options for a patient with acute disseminated encephalomyelitis (ADEM) suffering from iatrogenic Cushing’s symptoms
Alejandro Ponce Sepulveda
Clinical Research In Practice: The Journal of Team Hippocrates .2024;[Epub] CrossRef
Getting to the Diagnosis: A Case Study on a 51-Year-Old Female with Anxiety, Depression, and Suicidal Ideations
Stefanie Varela, Taqialdeen Zamil, Delfino Varela, Ayman Tailakh
Case Reports in Clinical Medicine.2024; 13(10): 456. CrossRef
Considerations for cutaneous physiologic changes of pregnancy that fail to resolve postpartum
Madison J. Anzelc, Mark A. Bechtel
International Journal of Dermatology.2023; 62(2): 190. CrossRef
Hypertension in Turner syndrome: a review of proposed mechanisms, management and new directions
Lily Jones, Joanne Blair, Daniel B. Hawcutt, Gregory Y.H. Lip, Alena Shantsila
Journal of Hypertension.2023; 41(2): 203. CrossRef
Methyl-Prednisolone and Betamethasone Induced Iatrogenic Cushing Syndrome - A Rare Case Report
Faaiz Khan, Jumana Hakeem, Mitta Raghavendra, Sushanta Kumar Das, Vallala Venakata Rajesham, Tadikonda Rama Rao
International Journal of Pharmaceutical Research and Allied Sciences.2023; 12(2): 40. CrossRef
Toward Systems-Level Metabolic Analysis in Endocrine Disorders and Cancer
Aliya Lakhani, Da Hyun Kang, Yea Eun Kang, Junyoung O. Park
Endocrinology and Metabolism.2023; 38(6): 619. CrossRef
A new model of the algorithm for differential diagnosis of Cushing’s disease and ectopic ACTH dependent syndrome
I. A. Rudakov, A. V. Savello, V. Yu. Cherebillo, A. A. Paltsev, N. V. Kuritsyna
Russian Neurosurgical Journal named after Professor A. L. Polenov.2023; 15(3): 103. CrossRef
Cortisol-Producing Adrenocortical Carcinoma Presenting with Hypertensive Emergency
Mitchell McGowan, Thomas Kalinoski
American Journal of Case Reports.2023;[Epub] CrossRef
Metabolic profile differences in ACTH‐dependent and ACTH‐independent Cushing syndrome
Zhengyang Li, Chen Zhang, Chong Geng, Yongfeng Song
Chronic Diseases and Translational Medicine.2022; 8(1): 36. CrossRef
Stressing the need for validated measures of cortisol in HIV research: A scoping review
Shayda A. Swann, Elizabeth M. King, Hélène C. F. Côté, Melanie C. M. Murray
HIV Medicine.2022; 23(8): 880. CrossRef
Concomitant coexistence of ACTH‐dependent and independent Cushing syndrome
Ach Taieb, Saad Ghada, Gorchène Asma, Ben Abdelkrim Asma, Kacem Maha, Ach Koussay
Clinical Case Reports.2022;[Epub] CrossRef
Incretin Response to Mixed Meal Challenge in Active Cushing’s Disease and after Pasireotide Therapy
Mattia Barbot, Alessandro Mondin, Daniela Regazzo, Valentina Guarnotta, Daniela Basso, Carla Giordano, Carla Scaroni, Filippo Ceccato
International Journal of Molecular Sciences.2022; 23(9): 5217. CrossRef
Intermittent Blurry Vision: An Unexpected Presentation of Cushing’s Syndrome Due to Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH)
Christopher Fernandez, Smriti Bhatia, Ariana Rucker, Lee Celio
Cureus.2022;[Epub] CrossRef
Recurrent Metatarsal Fractures in a Patient With Cushing Disease: A Case Report
Jose Iturregui, Glenn Shi
Cureus.2022;[Epub] CrossRef
Recognising and diagnosing Cushing’s syndrome in primary care: challenging but not impossible
Kate Scoffings, Damian Morris, Andrew Pullen, Sharon Temple, Anna Trigell, Mark Gurnell
British Journal of General Practice.2022; 72(721): 399. CrossRef
Recurrent Cushing Syndrome From Metastatic Adrenocortical Carcinoma With Fumarate Hydratase Allelic Variant
Emily Silverman, Noor Addasi, Muaataz Azzawi, Ernesto Martinez Duarte, Dali Huang, Benjamin Swanson, Apar Kishor Ganti, Gwen Reiser, Abbey L. Fingeret, Anupam Kotwal
AACE Clinical Case Reports.2022; 8(6): 259. CrossRef
Multiple Bone Fractures in a Patient With Difficult-to-Treat Cushing’s Disease
Sara Correia, Diogo Ramalho, Gustavo Rocha, Maria J Oliveira
Cureus.2022;[Epub] CrossRef
Management of patients on systemic steroids: An oral surgery perspective
Vikash Patel, Shrina Nathwani, Naomi Rahman
Dental Update.2022; 49(9): 749. CrossRef
Importancia del cateterismo de senos petrosos inferiores en el diagnóstico de síndrome de Cushing, a propósito de un caso
Clara Jiménez García, Paula Sirera Sirera, María Eugenia Torregrosa Quesada, Victoria González Bueno, Rocío Alfayate Guerra
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio.2022; 3(4): 411. CrossRef
Cushing's Syndrome Behind Hypokalemia and Severe Infection: A Case Report
Catarina Elias, Diana Oliveira, Maria Manuel Silva, Patrícia Lourenço
Cureus.2022;[Epub] CrossRef
Relevance of inferior petrosal sinus sampling in the diagnosis of Cushing’s syndrome: a case report
Clara Jiménez García, Paula Sirera Sirera, María Eugenia Torregrosa Quesada, Victoria González Bueno, Rocío Alfayate Guerra
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio.2022; 3(4): 407. CrossRef
Proximal muscle weakness as the sole manifestation of Cushing’s disease, misdiagnosed as dermatomyositis: a case report
Marjan Jeddi, Mesbah Shams
Journal of Medical Case Reports.2022;[Epub] CrossRef
Differences in outcomes of bilateral adrenalectomy in patients with ectopic ACTH producing tumor of known and unknown origin
Thomas Szabo Yamashita, Alaa Sada, Irina Bancos, William F. Young, Benzon M Dy, David R. Farley, Melanie L. Lyden, Geoffrey B. Thompson, Travis J. McKenzie
The American Journal of Surgery.2021; 221(2): 460. CrossRef
A key role for conservative treatment in the management of pituitary apoplexy
Claire Marx, Muriel Rabilloud, Françoise Borson Chazot, Caroline Tilikete, Emmanuel Jouanneau, Gerald Raverot
Endocrine.2021; 71(1): 168. CrossRef
7-T Magnetic Resonance Imaging in the Management of Brain Tumors
Melanie A. Morrison, Janine M. Lupo
Magnetic Resonance Imaging Clinics of North America.2021; 29(1): 83. CrossRef
Medical therapy in severe hypercortisolism
Júlia Vieira Oberger Marques, Cesar Luiz Boguszewski
Best Practice & Research Clinical Endocrinology & Metabolism.2021; 35(2): 101487. 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
Method-Specific Cortisol and Dexamethasone Thresholds Increase Clinical Specificity of the Dexamethasone Suppression Test for Cushing Syndrome
Nora Vogg, Max Kurlbaum, Timo Deutschbein, Benedict Gräsl, Martin Fassnacht, Matthias Kroiss
Clinical Chemistry.2021; 67(7): 998. CrossRef
Untargeted Plasma Metabolomics Unravels a Metabolic Signature for Tissue Sensitivity to Glucocorticoids in Healthy Subjects: Its Implications in Dietary Planning for a Healthy Lifestyle
Nicolas C. Nicolaides, Maria-Konstantina Ioannidi, Eleni Koniari, Ifigeneia Papageorgiou, Anastasia Bartzeliotou, Amalia Sertedaki, Maria I. Klapa, Evangelia Charmandari
Nutrients.2021; 13(6): 2120. CrossRef
Endocrine hypertension secondary to adrenal tumors: clinical course and predictive factors of clinical remission
Uriel Clemente-Gutiérrez, Rafael H. Pérez-Soto, Juan D. Hernández-Acevedo, Nicole M. Iñiguez-Ariza, Enrique Casanueva-Pérez, Juan Pablo Pantoja-Millán, Mauricio Sierra-Salazar, Miguel F. Herrera, David Velázquez-Fernández
Langenbeck's Archives of Surgery.2021; 406(6): 2027. CrossRef
Development of 68 Ga DOTA-CRH for PET/CT Imaging of ACTH-Dependent Cushing's Disease: Initial Study
Jaya Shukla, Rakhee Vatsa, Rama Walia, Anupriya Chhabra, Nivedita Rana, Harmandeep Singh, Rajender Kumar, Bhagwant Rai Mittal
Cancer Biotherapy and Radiopharmaceuticals.2021; 36(8): 642. CrossRef
Cushing Syndrome Associated Myopathy: It Is Time for a Change
Martin Reincke
Endocrinology and Metabolism.2021; 36(3): 564. CrossRef
Cushing’s disease presenting with psychosis
Ahmed Saeed Mubarak Mohamed, Ahmed Iqbal, Suveera Prasad, Nigel Hoggard, Daniel Blackburn
Practical Neurology.2021; 21(4): 351. CrossRef
ACTH-independent Cushing's syndrome due to bilateral adrenocortical adenoma: A case report
Majd Sharaf, Rama Al-Saqqa, Mouhammad Kourabi
Radiology Case Reports.2021; 16(11): 3168. CrossRef
A New Clinical Model to Estimate the Pre-Test Probability of Cushing’s Syndrome: The Cushing Score
Mirko Parasiliti-Caprino, Fabio Bioletto, Tommaso Frigerio, Valentina D’Angelo, Filippo Ceccato, Francesco Ferraù, Rosario Ferrigno, Marianna Minnetti, Carla Scaroni, Salvatore Cannavò, Rosario Pivonello, Andrea Isidori, Fabio Broglio, Roberta Giordano, M
Frontiers in Endocrinology.2021;[Epub] CrossRef
Bilateral Adrenalectomy: Differences between Cushing Disease and Ectopic ACTH-Producing Tumors
Thomas Szabo Yamashita, Alaa Sada, Irina Bancos, William F. Young, Benzon M. Dy, David R. Farley, Melanie L. Lyden, Geoffrey B. Thompson, Travis J. McKenzie
Annals of Surgical Oncology.2020; 27(10): 3851. CrossRef
Decision-Making in Artificial Intelligence: Is It Always Correct?
Hun-Sung Kim
Journal of Korean Medical Science.2020;[Epub] CrossRef
Cushing's syndrome: Overview of clinical presentation, diagnostic tools and complications
Mattia Barbot, Marialuisa Zilio, Carla Scaroni
Best Practice & Research Clinical Endocrinology & Metabolism.2020; 34(2): 101380. CrossRef
Cortisol Measurements in Cushing’s Syndrome: Immunoassay or Mass Spectrometry?
Gregori Casals, Felicia Alexandra Hanzu
Annals of Laboratory Medicine.2020; 40(4): 285. CrossRef
Cardiopatías de origen endocrino: una etiología frecuentemente olvidada
Laura Duque-González, Luis Miguel Ruiz-Velásquez, José Luis Torres-Grajales, Mauricio Duque-Ramírez
Medicina y Laboratorio.2020; 24(3): 207. CrossRef
Reference ranges of late-night salivary cortisol and cortisone measured by LC–MS/MS and accuracy for the diagnosis of Cushing’s syndrome
F. Ponzetto, F. Settanni, M. Parasiliti-Caprino, F. Rumbolo, A. Nonnato, M. Ricciardo, E. Amante, G. Priolo, S. Vitali, L. Anfossi, E. Arvat, E. Ghigo, R. Giordano, G. Mengozzi
Journal of Endocrinological Investigation.2020; 43(12): 1797. CrossRef
Assessment of 1 mg Dexamethasone Suppression Test in Patients with Obesity Before Bariatric Surgery
Dilek Gogas Yavuz, Tugce Apaydin, Hatice Gizem Gunhan, Meliha Melin Uygur
Obesity Surgery.2020; 30(12): 4981. CrossRef
Prospective Evaluation of Late-Night Salivary Cortisol and Cortisone by EIA and LC-MS/MS in Suspected Cushing Syndrome
Joshua Kannankeril, Ty Carroll, James W Findling, Bradley Javorsky, Ian L Gunsolus, Jonathan Phillips, Hershel Raff
Journal of the Endocrine Society.2020;[Epub] CrossRef
Infantile Iatrogenic Cushing Syndrome due to Topical Steroids
Lulwah Alkhuder, Horia Mawlawi
Case Reports in Pediatrics.2019; 2019: 1. CrossRef
Synchronous bilateral adrenalectomy in ACTH-dependent hypercortisolism: predictors, biomarkers and outcomes
S. Chiloiro, A. Giampietro, M. Raffaelli, G. D’Amato, C. Bima, L. Lauretti, C. Anile, C. P. Lombardi, G. Rindi, R. Bellantone, L. De Marinis, A. Pontecorvi, A. Bianchi
Endocrine.2019; 66(3): 642. CrossRef
Low-dose etomidate for the management of severe hypercortisolaemia in different clinical scenarios: a case series and review of the literature
Agnieszka Łebek-Szatańska, Karolina M. Nowak, Wojciech Zgliczyński, Elżbieta Baum, Agnieszka Żyłka, Lucyna Papierska
Therapeutic Advances in Endocrinology and Metabolism.2019;[Epub] CrossRef
Drug design strategies for Cushing’s syndrome
S. A. Usanov, A. V. Kliuchenovich, N. V. Strushkevich
Expert Opinion on Drug Discovery.2019; 14(2): 143. CrossRef
Pharmacological and analytical interference in hormone assays for diagnosis of adrenal incidentaloma
Antoine-Guy Lopez, François Fraissinet, Herve Lefebvre, Valéry Brunel, Frédéric Ziegler
Annales d'Endocrinologie.2019; 80(4): 250. CrossRef
Emerging Role of USP8, HMGA, and Non-Coding RNAs in Pituitary Tumorigenesis
Daniela D’Angelo, Marco De Martino, Claudio Arra, Alfredo Fusco
Cancers.2019; 11(9): 1302. CrossRef
Glucocorticoid Receptor Antagonist Administration Prevents Adrenal Gland Atrophy in an ACTH-Independent Cushing’s Syndrome Rat Model
Atsushi Yasuda, Toshiro Seki, Yoshie Kametani, Masahiro Koizumi, Natsumi Kitajima, Masayuki Oki, Masami Seki, Takatoshi Kakuta, Masafumi Fukagawa
International Journal of Endocrinology.2019; 2019: 1. CrossRef
Cushing’s Disease
Hiroshi Nishioka, Shozo Yamada
Journal of Clinical Medicine.2019; 8(11): 1951. CrossRef

Adrenal gland
Diagnosis and Treatment of Hypopituitarism: Seong Yeon Kim; Endocrinol Metab. 2015;30(4):443-455. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.443

40,486 View
903 Download
59 Web of Science
75 Crossref

Abstract PDF PubReader

Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. Clinical manifestations of hypopituitarism are variable, often insidious in onset and dependent on the degree and severity of hormone deficiency. However, it is associated with increased mortality and morbidity. Therefore, early diagnosis and prompt treatment is necessary. Hypopituitarism can be easily diagnosed by measuring basal pituitary and target hormone levels except growth hormone (GH) and adrenocorticotropic hormone (ACTH) deficiency. Dynamic stimulation tests are indicated in equivocal basal hormone levels and GH/ACTH deficiency. Knowledge of the use and limitations of these stimulation tests is mandatory for proper interpretation. It is necessary for physicians to inform their patients that they may require lifetime treatment. Hormone replacement therapy should be individualized according to the specific needs of each patient, taking into account possible interactions. Long-term endocrinological follow-up of hypopituitary patients is important to monitor hormonal replacement regimes and avoid under- or overtreatment.

Citations

Citations to this article as recorded by

Traumatic Brain Injury – Prevalence, Pathophysiology and Treatment of Neuroendocrine Dysfunction: A Narrative Review
Saumya Susan Zacharia, Kripa Elizabeth Cherian, Raji Thomas, Thomas Vizhalil Paul
Indian Journal of Physical Medicine and Rehabilitation.2026; 36(1): 7. CrossRef
Clinico-etiological Profile of Hypopituitarism: Observations from a Tertiary Care Experience in Eastern India
Rupak Chatterjee, Upoma Saha, Anubhav Chakraborty, Shatavisa Mukherjee, Soumitra Ghosh, Salil Kumar Pal, Nandini Chatterjee
APIK Journal of Internal Medicine.2026; 14(2): 114. CrossRef
Navigating the “specific etiology” steatohepatitis category: Evaluation and management of nonalcohol/nonmetabolic dysfunction–associated steatohepatitis
Mohammad Qasim Khan, Sara Hassan, Blanca C. Lizaola-Mayo, Mamatha Bhat, Kymberly D. Watt
Hepatology.2025; 82(2): 504. CrossRef
Protective Strategies for Pituitary Function During Endoscopic Transnasal Pituitary Adenoma Surgery: A Single-center Experience
Jihu Yang, Fengmin Zhang, Sihao Chen, Xiejun Zhang, Yufei Liu, Wenjian Zheng, Fanfan Chen, Lei Chen, Guodong Huang
Journal of Craniofacial Surgery.2025; 36(4): 1207. CrossRef
A disturbed communication between hypothalamic-pituitary-ovary axis and gut microbiota in female infertility: is diet to blame?
Fatima Ahmad, Salma H Ahmed, Fadi Choucair, Spyridon Chouliaras, Johnny Awwad, Annalisa Terranegra
Journal of Translational Medicine.2025;[Epub] CrossRef
Cardiovascular Consequences Unveiled: A Comprehensive Review of Hypopituitarism’s Impact on the Heart
Mengmei Li, Xiaowen Zhen, Hongqiao Sun, Jing Wang
Cardiology in Review.2025;[Epub] CrossRef
Development of a Long-Acting Follicle-Stimulating Hormone Using Serum Albumin Fab-Associated Technology for Female Infertility
Daham Kim, Yoon Hee Cho, Min Jeong Kang, So Jeong Lee, Soohyun Lee, Bo Hyon Yun, Hyunjin Chi, Jeongsuk An, Kyungsun Lee, Jaekyu Han, Susan Chi, Moo Young Song, Sang-Hoon Cha, Eun Jig Lee
Endocrinology and Metabolism.2025; 40(1): 146. CrossRef
Machine Learning-Based Modeling for Predicting Hypopituitarism After Cranial Trauma
Ai Chen, Hua Zhong, Jie Peng, Tao Luo, Su Jun
World Neurosurgery.2025; 199: 124018. CrossRef
Extracorporeal cardiopulmonary resuscitation for sudden cardiac arrest induced by septic shock-related adrenal crisis
Martin Pažitný, Matúš Maruniak, Martin Ilenin, Dušan Rybár, Tomáš Grendel
Turkish Journal of Emergency Medicine.2025; 25(3): 242. CrossRef
CHARACTERISTICS OF ADRENAL INSUFFICIENCY IN PATIENTS UNDERGOING HEMODIALYSIS FOR END-STAGE KIDNEY FAILURE
Mehmet Polat, Seda Basmaz
Problems of Endocrine Pathology.2025; 82(3): 14. CrossRef
Progression From Isolated Posterior Pituitary Dysfunction to Combined Anterior Hormone Deficiencies With Pituitary Stalk Enlargement in Suspected Lymphocytic Hypophysitis: A Case Report
Hironobu Sasaki, Kazuma Yagi, Yoko Kuga, Haruki Katahira
Cureus.2025;[Epub] CrossRef
Nomogram prediction model for postoperative anterior pituitary dysfunction in patients with nonfunctioning pituitary adenomas: A multidimensional analysis and validation of Short-Term and Mid-to-Long-Term outcomes
Zihong Yao, Danxia Xu, Yuxin Xie, Haixue Jing, Hui Chen
Endocrine.2025;[Epub] CrossRef
Central Endocrine Complications Among Childhood Cancer Survivors Treated With Radiation Therapy: A PENTEC Comprehensive Review
Greg Wheeler, Clemens Grassberger, Josephine Samers, Mary Dwyer, Kirsty Wiltshire, Patricia Daly, Beatriz Alvarez, Belinda A. Campbell, Amanda J. Kerr, Tomas Kron, Frances K. Duane, Margaret Zacharin, Peter Downie, Elizabeth Kyriakou, Cecile M. Ronckers,
International Journal of Radiation Oncology*Biology*Physics.2024; 119(2): 457. CrossRef
Pituitary stem cells: past, present and future perspectives
María Inés Pérez Millán, Leonard Y. M. Cheung, Florencia Mercogliano, Maria Andrea Camilletti, Gonzalo T. Chirino Felker, Lucia N. Moro, Santiago Miriuka, Michelle L. Brinkmeier, Sally A. Camper
Nature Reviews Endocrinology.2024; 20(2): 77. CrossRef
Idiopathic isolated adrenocorticotropic hormone deficiency: a systematic review of a heterogeneous and underreported disease
E. Van Mieghem, C. De Block, C. De Herdt
Pituitary.2024; 27(1): 23. CrossRef
Perioperative growth hormone levels as an early predictor of new-onset secondary adrenal insufficiency following transsphenoidal pituitary tumor resection
Fon-Yih Tsuang, Shyang-Rong Shih, Ham-Min Tseng, Huan-Chih Wang
Asian Journal of Surgery.2024; 47(4): 1746. CrossRef
A comprehensive review of the new FIGO classification of ovulatory disorders
Adam H Balen, Jennifer Tamblyn, Karolina Skorupskaite, Malcolm G Munro
Human Reproduction Update.2024; 30(3): 355. CrossRef
Panhypopituitarism caused by a suprasellar germinoma: A case report
Jelena Roganovic, Lea Saric, Silvije Segulja, Ana Dordevic, Mia Radosevic
World Journal of Clinical Cases.2024; 12(10): 1844. CrossRef
Utility of copeptin in predicting non-pathological postoperative polyuria in patients affected by acromegaly undergoing pituitary neurosurgery
Emanuele Varaldo, Nunzia Prencipe, Alessandro Maria Berton, Luigi Simone Aversa, Fabio Bioletto, Raffaele De Marco, Valentina Gasco, Francesco Zenga, Silvia Grottoli
Pituitary.2024; 27(5): 488. CrossRef
Neuroendocrine challenges and clinical outcomes in men with chronic traumatic brain injury: a cross-sectional study
Saumya Susan Zacharia, Raji Thomas, Johns T Johnson, Nitin Kapoor, Saraswathi Ramanathan, Hesarghatta S Asha, Kripa Elizabeth Cherian, Thomas V Paul
Pituitary.2024; 27(5): 693. CrossRef
Manifestations of Endocrine Disease in the Lower Extremities: Beyond the Diabetic Foot
Kleoniki I. Athanasiadou, Christothea A. Tsiridis, Ioanna A. Paschou, Stavroula A. Paschou, Nikolaos Papanas
The International Journal of Lower Extremity Wounds.2024;[Epub] CrossRef
Unveiling a syndrome through recurrent hypoglycemia
Saadi AlJadir
Obstetrics & Gynecology International Journal.2024; 15(5): 247. CrossRef
Hypopituitarism in a patient with breast cancer
Łukasz Lisak, Aleksandra Kaźmierczak, Anna Kaletka
Biuletyn Głównej Biblioteki Lekarskiej.2024; 57(383): 83. CrossRef
Decreased mannan-binding lectin level in adults with hypopituitarism; dependence on appropriate hormone replacement therapies
Aleksandra E. Matusiak, Jan Stępniak, Andrzej Lewiński, Małgorzata Karbownik-Lewińska
Frontiers in Immunology.2023;[Epub] CrossRef
Post-Operative Medium- and Long-Term Endocrine Outcomes in Patients with Non-Functioning Pituitary Adenomas—Machine Learning Analysis
Ziad Hussein, Robert W. Slack, Hani J. Marcus, Evangelos B. Mazomenos, Stephanie E. Baldeweg
Cancers.2023; 15(10): 2771. CrossRef
The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels
Sara Ellegaard Christensen, Liv Norma Smith, Christian Alexander H. Rosendal, Helga Angela Gulisano, Kåre Schmidt Ettrup, Peter Vestergaard, Eigil Husted Nielsen, Jesper Scott Karmisholt, Jakob Dal
Frontiers in Endocrinology.2023;[Epub] CrossRef
Sheehan’s syndrome unveiled after decades without a diagnosis: A case report
Hadi Rabee’, Tamara Braik, Rezeq Alnatour, Alaa Shamlawi, Ammar Rashed
SAGE Open Medical Case Reports.2023;[Epub] CrossRef
PAN-HIPOPITUITARISMO SECUNDÁRIO A INFECÇÃO POR SARS-COV-2: RELATO DE CASO
Rosyane Luz Rufino De Lima, Viviane dos Reis Vieira Yance
REVISTA FOCO.2023; 16(12): e3832. CrossRef
Regulation of the Hypothalamic-Pituitary-Testicular Axis: Pathophysiology of Hypogonadism
Aditi Sharma, Channa N. Jayasena, Waljit S. Dhillo
Endocrinology and Metabolism Clinics of North America.2022; 51(1): 29. CrossRef
Penetrating brain injury with hypopituitarism
Rachel D. Appelbaum, Kristina E. Neri, Kristin A. Rebo, Samuel P. Carmichael
Trauma Case Reports.2022; 38: 100628. CrossRef
Risk of Mental Illnesses in Patients With Hypopituitarism: A Nationwide Population-Based Cohort Study
I-Hua Wei, Chih-Chia Huang
Psychiatry Investigation.2022; 19(6): 418. CrossRef
Pituitary Apoplexy and Subdural Hematoma after Caesarean Section
Van Trung Hoang, The Huan Hoang, Thanh Tam Thi Nguyen, Vichit Chansomphou, Duc Thanh Hoang, Kyousuke Takeuchi
Case Reports in Obstetrics and Gynecology.2022; 2022: 1. CrossRef
A Unique Case Mimicking Sepsis

Journal of Acute Care.2022; 1(1): 29. CrossRef
Correlation between shift work and non-alcoholic fatty liver disease among male workers in the steel manufacturing company of Korea: a cross-sectional study
Kiseok Kim, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Hyun Kyo Lee, Gwangin Baek, Sang Hyeon Kim, Eun-Chul Jang
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Non-alcoholic fatty liver disease across endocrinopathies: Interaction with sex hormones
Sara Arefhosseini, Mehrangiz Ebrahimi-Mameghani, Farzad Najafipour, Helda Tutunchi
Frontiers in Endocrinology.2022;[Epub] CrossRef
Primary hypothyroidism and postmenopause as the causes of delayed diagnosis of panhypopituitarism in a patient with nonfunctional pituitary adenoma
E. G. Ryzhkova, D. O. Ladygina
Problems of Endocrinology.2022; 68(5): 32. CrossRef
Efficacy and Safety of Stereotactic Radiotherapy in Cushing’s Disease: A Single Center Experience
Tugce Apaydin, Hande Mefkure Ozkaya, Sebnem Memis Durmaz, Rasim Meral, Pinar Kadioglu
Experimental and Clinical Endocrinology & Diabetes.2021; 129(07): 482. CrossRef
Metabolic and Endocrine Challenges
Gennaro Martucci, Eleonora Bonicolini, Dhruv Parekh, Onn Shaun Thein, Mario Scherkl, Karin Amrein
Seminars in Respiratory and Critical Care Medicine.2021; 42(01): 078. CrossRef
The Effect of Pituitary Gland Disorders on Glucose Metabolism: From Pathophysiology to Management
Guy I. Sydney, Konstantinos Michalakis, Ilias P. Nikas, Eleftherios Spartalis, Stavroula A. Paschou
Hormone and Metabolic Research.2021; 53(01): 16. CrossRef
Congenital hypopituitarism in two brothers with a duplication of the ‘acrogigantism gene’ GPR101: clinical findings and review of the literature
Melitza S. M. Elizabeth, Annemieke J. M. H. Verkerk, Anita C. S. Hokken-Koelega, Joost A. M. Verlouw, Jesús Argente, Roland Pfaeffle, Sebastian J. C. M. M. Neggers, Jenny A. Visser, Laura C. G. de Graaff
Pituitary.2021; 24(2): 229. CrossRef
Association between Nonalcoholic Fatty Liver Disease and Endocrinopathies: Clinical Implications
Ana-Maria Singeap, Carol Stanciu, Laura Huiban, Cristina Maria Muzica, Tudor Cuciureanu, Irina Girleanu, Stefan Chiriac, Sebastian Zenovia, Robert Nastasa, Catalin Sfarti, Camelia Cojocariu, Anca Trifan, Branka Filipović
Canadian Journal of Gastroenterology and Hepatology.2021;[Epub] CrossRef
The evaluation of pituitary damage associated with cardiac arrest: An experimental rodent model
Yu Okuma, Tomoaki Aoki, Santiago J. Miyara, Kei Hayashida, Mitsuaki Nishikimi, Ryosuke Takegawa, Tai Yin, Junhwan Kim, Lance B. Becker, Koichiro Shinozaki
Scientific Reports.2021;[Epub] CrossRef
Functional Restoration of Pituitary after Pituitary Allotransplantation into Hypophysectomized Rats
Jai Ho Choi, Jung Eun Lee, Hong-Lim Kim, Seung Hyun Ko, Se Hoon Kim, Seung Ho Yang
Cells.2021; 10(2): 267. CrossRef
Experience of a Pituitary Clinic for US Military Veterans With Traumatic Brain Injury
Jonathan Lee, Lindsey J Anderson, Dorota Migula, Kevin C J Yuen, Lisa McPeak, Jose M Garcia
Journal of the Endocrine Society.2021;[Epub] CrossRef
Biogenic zinc-oxide nanoparticles of Moringa oleifera leaves abrogates rotenone induced neuroendocrine toxicity by regulation of oxidative stress and acetylcholinesterase activity
J.K. Akintunde, T.I. Farai, M.R. Arogundade, J.T. Adeleke
Biochemistry and Biophysics Reports.2021; 26: 100999. CrossRef
Heart Rate Variability in Postoperative Patients with Nonfunctioning Pituitary Adenoma
Jeonghoon Ha, Hansang Baek, Chaiho Jeong, Minsoo Yeo, Seung-Hwan Lee, Jae Hyoung Cho, Ki-Hyun Baek, Moo Il Kang, Dong-Jun Lim
Endocrinology and Metabolism.2021; 36(3): 678. CrossRef
Aetiologies and clinical patterns of hypopituitarism in Sudanese children
Samar Hassan, Renson Mukhwana, Salwa Musa, Areej Ibrahim, Omer Babiker, Mohamed Abdullah
Sudanese Journal of Paediatrics.2021; : 53. CrossRef
Recent advances in proteomics and its implications in pituitary endocrine disorders
Arghya Banerjee, Atul Goel, Abhidha Shah, Sanjeeva Srivastava
Biochimica et Biophysica Acta (BBA) - Proteins and Proteomics.2021; 1869(11): 140700. CrossRef
Morning Serum Cortisol as a Predictor for the HPA Axis Recovery in Cushing’s Disease
Q. Cui, D. Liu, B. Xiang, Q. Sun, L. Fan, M. He, Y. Wang, X. Zhu, H. Ye, Giorgio Borretta
International Journal of Endocrinology.2021; 2021: 1. CrossRef
Three different faces of TACI mutations
Sukru Cekic, Fatih Cicek, Yasin Karali, Orhan Gorukmez, Erdal Eren, Sara Sebnem Kilic
Scandinavian Journal of Immunology.2020;[Epub] CrossRef
Treatment of a Woman with Inoperable Meningioma Using Mifepristone for 26 Years
Maria das Dores Medina-Lopes, Luiz Augusto Casulari
Case Reports in Neurological Medicine.2020; 2020: 1. CrossRef
Diagnosis and Treatment of Growth Hormone Deficiency: A Position Statement from Korean Endocrine Society and Korean Society of Pediatric Endocrinology
Jung Hee Kim, Hyun Wook Chae, Sang Ouk Chin, Cheol Ryong Ku, Kyeong Hye Park, Dong Jun Lim, Kwang Joon Kim, Jung Soo Lim, Gyuri Kim, Yun Mi Choi, Seong Hee Ahn, Min Ji Jeon, Yul Hwangbo, Ju Hee Lee, Bu Kyung Kim, Yong Jun Choi, Kyung Ae Lee, Seong-Su Moon
Endocrinology and Metabolism.2020; 35(2): 272. CrossRef
Phenytoin- Medication That Warrants Deviation From Standard Approach for Thyroid Lab Interpretation
Vishwanath Pattan, Narsimha Candula, Ramesh Adhikari, Rahul Kashyap
Cureus.2020;[Epub] CrossRef
Pituitary Disorders in Pregnancy
Whitney W. Woodmansee
Neurologic Clinics.2019; 37(1): 63. CrossRef
A clinical case of partial hypopituitarism
T. E. Pomytkina
Fundamental and Clinical Medicine.2019; 4(3): 122. CrossRef
Mesencephalic Astrocyte-Derived Neurotrophic Factor (MANF) Is Highly Expressed in Mouse Tissues With Metabolic Function
Tatiana Danilova, Emilia Galli, Emmi Pakarinen, Erik Palm, Päivi Lindholm, Mart Saarma, Maria Lindahl
Frontiers in Endocrinology.2019;[Epub] CrossRef
Functional survival of rat pituitary gland in hypothermic storage for pituitary transplantation
Jai Ho Choi, Jung Eun Lee, Se Hoon Kim, Hong-Lim Kim, Sin Soo Jeun, Seung Ho Yang
Pituitary.2019; 22(4): 353. CrossRef
Fertility after transsphenoidal surgery in patients with prolactinomas: A meta-analysis
Nayan Lamba, Nadia Noormohamed, Thomas Simjian, Mona Y. Alsheikh, Alykhan Jamal, Joanne Doucette, Hasan Zaidi, Timothy R. Smith, Rania A. Mekary
Clinical Neurology and Neurosurgery.2019; 176: 53. CrossRef
Traumatic brain injury and hypopituitarism
Sarah Leeder
Advances in Clinical Neuroscience & Rehabilitation.2019;[Epub] CrossRef
Long-acting FC-fusion rhGH (GX-H9) shows potential for up to twice-monthly administration in GH-deficient adults
Cheol Ryong Ku, Thierry Brue, Katharina Schilbach, Stanislav Ignatenko, Sandor Magony, Yoon-Sok Chung, Byung-Joon Kim, Kyu Yeon Hur, Ho-Cheol Kang, Jung Hee Kim, Min Seon Kim, Aldona Kowalska, Marek Bolanowski, Marek Ruchala, Svetozar Damjanovic, Juraj Pa
European Journal of Endocrinology.2018; 179(3): 169. CrossRef
Prolactinomas Resistant to Treatment With Dopamine Agonists: Long-Term Follow-Up of Six Cases
Maria de Fátima de Magalhães Gonzaga, Lucas Faria de Castro, Luciana Ansaneli Naves, José Luiz Mendonça, Benicio Oton de Lima, Iruena Kessler, Luiz Augusto Casulari
Frontiers in Endocrinology.2018;[Epub] CrossRef
Oxytocin and Naltrexone Successfully Treat Hypothalamic Obesity in a Boy Post-Craniopharyngioma Resection
Eugenie A Hsu, Jennifer L Miller, Francisco A Perez, Christian L Roth
The Journal of Clinical Endocrinology & Metabolism.2018; 103(2): 370. CrossRef
Spectrum of Sellar and Parasellar Region Lesions: A retrospective study from Basrah, Iraq
Abbas Ali Mansour, Ali Hussain Ali Alhamza, Ammar Mohammed Saeed Abdullah Almomin, Ibrahim Abbood Zaboon, Nassar Taha Yaseen Alibrahim, Rudha Naser Hussein, Muayad Baheer Kadhim, Haider Ayad Yassin Alidrisi, Hussein Ali Nwayyir, Adel Gassab Mohammed, Dhey
F1000Research.2018; 7: 430. CrossRef
Delayed Complications After Transsphenoidal Surgery for Pituitary Adenomas
Gmaan Alzhrani, Walavan Sivakumar, Min S. Park, Philipp Taussky, William T. Couldwell
World Neurosurgery.2018; 109: 233. CrossRef
Hypopituitarism: Case Study Involving Hypernatremia Prompting Discovery of a Pituitary Disorder in a Patient With Lymphoma
Jace Johnny
Clinical Journal of Oncology Nursing.2018; 22(4): E115. CrossRef
Reflex and reflective testing strategies for early detection of pituitary dysfunction
Manal Elnenaei, Derek Minney, David B. Clarke, Andrew Kumar-Misir, Syed Ali Imran
Clinical Biochemistry.2018; 54: 78. 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
The Incidence of Anterior Pituitary Hormone Deficiencies in Patients with Pituitary Microadenoma and Idiopathic Hyperprolactinaemia. A Retrospective Single Centre Study

Journal of Clinical Review & Case Reports.2018;[Epub] CrossRef
Spectrum of Pituitary disorders: A retrospective study from Basrah, Iraq
Abbas Ali Mansour, Ali Hussain Ali Alhamza, Ammar Mohammed Saeed Abdullah Almomin, Ibrahim Abbood Zaboon, Nassar Taha Yaseen Alibrahim, Rudha Naser Hussein, Muayad Baheer Kadhim, Haider Ayad Yassin Alidrisi, Hussein Ali Nwayyir, Adel Gassab Mohammed, Dhey
F1000Research.2018; 7: 430. CrossRef
Growth Hormone & Hypopituitarism
Lahiry Sandeep
Journal of Analytical & Pharmaceutical Research.2017;[Epub] CrossRef
Using the Complexity of Hypopituitarism Aetiology to Understand and Teach Hormone Function in Endocrinology
Ayisha Qureshi
MOJ Anatomy & Physiology.2017;[Epub] CrossRef
Delayed diagnosis of pituitary stalk interruption syndrome with severe recurrent hyponatremia caused by adrenal insufficiency
Kyung Mi Jang, Cheol Woo Ko
Annals of Pediatric Endocrinology & Metabolism.2017; 22(3): 208. CrossRef
Indicaciones e interpretación diagnóstica de las pruebas funcionales hipofisarias
C. Tasende Fernández, M.J. Rodríguez Troyano, D.S. Trifu, P. Gómez Montes
Medicine - Programa de Formación Médica Continuada Acreditado.2016; 12(15): 865. CrossRef
Hypopituitarism in the elderly: a narrative review on clinical management of hypothalamic–pituitary–gonadal, hypothalamic–pituitary–thyroid and hypothalamic–pituitary–adrenal axes dysfunction
L. Curtò, F. Trimarchi
Journal of Endocrinological Investigation.2016; 39(10): 1115. CrossRef
Hipopituitarismo. Panhipopituitarismo
N. Peláez Torres, D.S. Trifu, M.P Gómez Montes, E. Atienza Sánchez
Medicine - Programa de Formación Médica Continuada Acreditado.2016; 12(15): 857. CrossRef

Original Article

Adrenal gland
Limited Diagnostic Utility of Plasma Adrenocorticotropic Hormone for Differentiation between Adrenal Cushing Syndrome and Cushing Disease: A Ram Hong, Jung Hee Kim, Eun Shil Hong, I Kyeong Kim, Kyeong Seon Park, Chang Ho Ahn, Sang Wan Kim, Chan Soo Shin, Seong Yeon Kim; Endocrinol Metab. 2015;30(3):297-304. Published online August 4, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.3.297

14,802 View
103 Download
15 Web of Science
15 Crossref

Abstract PDF PubReader

Background

Measurement of the plasma adrenocorticotropic hormone (ACTH) level has been recommended as the first diagnostic test for differentiating between ACTH-independent Cushing syndrome (CS) and ACTH-dependent CS. When plasma ACTH values are inconclusive, a differential diagnosis of CS can be made based upon measurement of the serum dehydroepiandrosterone sulfate (DHEA-S) level and results of the high-dose dexamethasone suppression test (HDST). The aim of this study was to assess the utility of plasma ACTH to differentiate adrenal CS from Cushing' disease (CD) and compare it with that of the HDST results and serum DHEA-S level.

Methods

We performed a retrospective, multicenter study from January 2000 to May 2012 involving 92 patients with endogenous CS. The levels of plasma ACTH, serum cortisol, 24-hour urine free cortisol (UFC) after the HDST, and serum DHEA-S were measured.

Results

Fifty-seven patients had adrenal CS and 35 patients had CD. The area under the curve of plasma ACTH, serum DHEA-S, percentage suppression of serum cortisol, and UFC after HDST were 0.954, 0.841, 0.950, and 0.997, respectively (all P<0.001). The cut-off values for plasma ACTH, percentage suppression of serum cortisol, and UFC after HDST were 5.3 pmol/L, 33.3%, and 61.6%, respectively. The sensitivity and specificity of plasma ACTH measurement were 84.2% and 94.3%, those of serum cortisol were 95.8% and 90.6%, and those of UFC after the HDST were 97.9% and 96.7%, respectively.

Conclusion

Significant overlap in plasma ACTH levels was seen between patients with adrenal CS and those with CD. The HDST may be useful in differentiating between these forms of the disease, especially when the plasma ACTH level alone is not conclusive.

Citations

Citations to this article as recorded by

Dehydroepiandrosterone sulfate as a potential biomarker for assessing the etiology of canine naturally occurring Cushing’s syndrome
Inês Oliveira, Patrícia Marques, Francesca Del Baldo, Mariachiara Re, Luísa Mateus, Rodolfo Oliveira Leal
Domestic Animal Endocrinology.2026; 95: 106993. CrossRef
Consensus on the diagnosis of Cushing’s disease: a collaborative statement from the Korean Endocrine Society and Japan Endocrine Society
Jeongmin Lee, Hidenori Fukuoka, Seung Shin Park, A Ram Hong, Jung Hee Kim, Sang Ouk Chin, Han-Sang Baek, Dong-Jun Lim, Kazunori Kageyama, Mitsuru Nishiyama, Shigeyuki Tahara, Ken-Ichi Oyama, Akira Sugawara, Miho Yamashita, Naoko Inoshita, Hiroshi Arima, B
Endocrine Journal.2026; 73(2): 355. CrossRef
Consensus on the Diagnosis of Cushing’s Disease: A Collaborative Statement from the Korean Endocrine Society and Japan Endocrine Society
Jeongmin Lee, Hidenori Fukuoka, Seung Shin Park, A Ram Hong, Jung Hee Kim, Sang Ouk Chin, Han-Sang Baek, Dong-Jun Lim, Kazunori Kageyama, Mitsuru Nishiyama, Shigeyuki Tahara, Kenichi Oyama, Akira Sugawara, Miho Yamashita, Naoko Inoshita, Hiroshi Arima, By
Endocrinology and Metabolism.2026; 41(1): 1. CrossRef
Diagnostic Utility of ACTH, Cortisol, DHEAS, and Their Derived Ratios in Cushing’s Syndrome Subtypes
Ekin Yiğit Köroğlu, Abbas Ali Tam, Sevgül Faki, Pervin Demir, Fatma Neslihan Çuhaci Seyrek, Didem Özdemir, Oya Topaloğlu, Reyhan Ersoy, Bekir Çakir
Journal of Clinical Medicine.2026; 15(7): 2772. CrossRef
Diagnosis of Cushing’s Disease
Henrik Elenius, Lynnette K. Nieman
Endocrinology and Metabolism Clinics of North America.2025; 54(4): 537. CrossRef
Development of diagnostic algorithm for Cushing’s syndrome: a tertiary centre experience
A. Efthymiadis, H. Loo, B. Shine, T. James, B. Keevil, J. W. Tomlinson, A. Pal, R. Pofi
Journal of Endocrinological Investigation.2024; 47(10): 2449. CrossRef
Eurasian clinical guidelines for the diagnosis and treatment of secondary (symptomatic) forms of arterial hypertension (2022)
I. E. Chazova, N. M. Chikhladze, N. V. Blinova, Zh. E. Belaya, N. M. Danilov, E. M. Elfimova, A. Yu. Litvin, L. Ya. Rozhinskaya, N. Yu. Sviridenko, M. Yu. Shvetsov, V. A. Azizov, E. A. Grigorenko, N. P. Mit’kovskaja, I. I. Mustafaev, A. G. Polupanov, A. S
Eurasian heart journal.2023; (1): 6. CrossRef
Diagnosis and Management of Pituitary Adenomas
Nicholas A. Tritos, Karen K. Miller
JAMA.2023; 329(16): 1386. CrossRef
Distinct serum steroid profiles between adrenal Cushing syndrome and Cushing disease
Chang Gao, Li Ding, Xiaona Zhang, Menghua Yuan, Shaofang Tang, Wei Li, Yuanyuan Ye, Ming Liu, Qing He
Frontiers in Endocrinology.2023;[Epub] CrossRef
The Importance of DHEA-S Levels in Cushing’s Syndrome; Is There a Cut-off Value in the Differential Diagnosis?
Sema Ciftci, Ozlem Soyluk, Alev Selek, Selvinaz Erol, Zeliha Hekimsoy, Ayse Esen, Huseyin Dursun, Serdar Sahin, Gonca Oruk, Meral Mert, Huseyin Soylu, Banu Sarer Yurekli, Melek Eda Ertorer, Tulay Omma, Mehtap Evran, Mine Adas, Seher Tanrikulu, Kadriye Ayd
Hormone and Metabolic Research.2022; 54(04): 232. CrossRef
Epidemiology and Comorbidity of Adrenal Cushing Syndrome: A Nationwide Cohort Study
Chang Ho Ahn, Jung Hee Kim, Man Young Park, Sang Wan Kim
The Journal of Clinical Endocrinology & Metabolism.2021; 106(3): e1362. 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
Clinical and Molecular Characteristics of PRKACA L206R Mutant Cortisol-Producing Adenomas in Korean Patients
Insoon Jang, Su-jin Kim, Ra-Young Song, Kwangsoo Kim, Seongmin Choi, Jang-Seok Lee, Min-Kyeong Gwon, Moon Woo Seong, Kyu Eun Lee, Jung Hee Kim
Endocrinology and Metabolism.2021; 36(6): 1287. 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
Cushing's syndrome: a practical approach to diagnosis and differential diagnoses
Joseph M Pappachan, Christian Hariman, Mahamood Edavalath, Julian Waldron, Fahmy W Hanna
Journal of Clinical Pathology.2017; 70(4): 350. CrossRef

Review Article

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

19,512 View
301 Download
17 Web of Science
22 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

Consensus on the diagnosis of Cushing’s disease: a collaborative statement from the Korean Endocrine Society and Japan Endocrine Society
Jeongmin Lee, Hidenori Fukuoka, Seung Shin Park, A Ram Hong, Jung Hee Kim, Sang Ouk Chin, Han-Sang Baek, Dong-Jun Lim, Kazunori Kageyama, Mitsuru Nishiyama, Shigeyuki Tahara, Ken-Ichi Oyama, Akira Sugawara, Miho Yamashita, Naoko Inoshita, Hiroshi Arima, B
Endocrine Journal.2026; 73(2): 355. CrossRef
Consensus on the Diagnosis of Cushing’s Disease: A Collaborative Statement from the Korean Endocrine Society and Japan Endocrine Society
Jeongmin Lee, Hidenori Fukuoka, Seung Shin Park, A Ram Hong, Jung Hee Kim, Sang Ouk Chin, Han-Sang Baek, Dong-Jun Lim, Kazunori Kageyama, Mitsuru Nishiyama, Shigeyuki Tahara, Kenichi Oyama, Akira Sugawara, Miho Yamashita, Naoko Inoshita, Hiroshi Arima, By
Endocrinology and Metabolism.2026; 41(1): 1. CrossRef
Ablation for Aldosterone-Producing versus Cortisol-Producing Adrenal Adenomas: A Comprehensive Review
Byung Kwan Park, Jae Hyeon Kim, Young Lyun Oh, Jung-Han Kim
Journal of Vascular and Interventional Radiology.2026; 37(9): 108894. CrossRef
Clinical Implications of Molecular and Genetic Biomarkers in Cushing’s Disease: A Literature Review
Laura Chinezu, Maximilian Cosma Gliga, Mihnea Bogdan Borz, Camelia Gliga, Ionela Maria Pascanu
Journal of Clinical Medicine.2025; 14(9): 3000. CrossRef
Bilateral Adrenal Ablation for the Treatment of Ectopic ACTH Syndrome With Severe Hypokalemia: A Case Report and a Literature Review
Fang Sun, Yuyu Sun, Hongbo He, Zhigang Zhao, Hexuan Zhang, Nan Jiang, Zhiming Zhu
Clinical Case Reports.2025;[Epub] CrossRef
Cushing’s syndrome due to Carney complex in two siblings
Akhila Panduranga Bhandarkar, Laxminarayana Samaga, Shrikrishna Acharya, Sathvika Bonigi, Lakshmi Nagendra
BMJ Case Reports.2025; 18(8): e264760. CrossRef
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

A Case of Ectopic ACTH Syndrome Associated with Metastatic Prostate Cancer.: Eun Ky Kim, Soo Heon Kwak, Hwa Young Ahn, Ah Reum Khang, Hyo Jin Park, So Yeon Park, Sang Eun Lee, Hak Chul Jang, Seong Yeon Kim, Young Joo Park; Endocrinol Metab. 2012;27(3):237-243. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.237

3,502 View
28 Download
1 Crossref

Abstract PDF

Ectopic adrenocorticotropic hormone (ACTH) syndrome is mostly associated with neuroendocrine tumors and small cell carcinoma of the lung. This syndrome of prostate cancer is rare and has been reported in only a few cases. We report a patient with ectopic ACTH production associated with metastatic prostate cancer. A 70-year-old patient with metastatic prostate cancer was admitted to our hospital with septic shock. He had a history of hormonal therapy and transurethral prostatectomy. Adrenocortical function was checked due to consistent fever and poor general condition, which revealed markedly increased levels of basal plasma ACTH and serum cortisol. The patient did not present typical signs of the Cushing's syndrome, however, hypokalemia and a history of hypertension were found. He died in days as a result of multi-organ failure. On pathology, the prostatectomy specimen showed a tumor composed of mixed populations of adenocarcinoma and small cell carcinoma. The tumor cells in the small cell component were positive for chromogranin and ACTH. Although neuroendocrine differentiation in prostate cancer is rare, etopic ACTH production should be considered in patients with prostate cancer as well as in clinical features of ACTH hypersecretion.

Citations

Citations to this article as recorded by

Severe Cushing Syndrome From Ectopic Adrenocorticotropin Secretion In Metastatic Prostate Cancer Treated With Osilodrostat
Beisi Ji, Lauren K Lynch, Sharon L Wardlaw
JCEM Case Reports.2025;[Epub] CrossRef

First
Prev
Page of 1
Next
Last

Search