The patient's Cushing disease is currently in remission and her amenorrhea is resolving, with the additional symptoms of hyperandrogenic hypogonadism improving over time.
Appropriate treatment of this patient for Cushing disease was delayed due to misdiagnosis, which is frequent in patients with this fairly rare condition.
Cushing described basophilic adenomas of the pituitary associated with
Cushing disease and described Cushing syndrome--the clinical effects of hyperadrenalism.
We identified a subset of 21 patients who had undergone pituitary surgery for
Cushing disease and had remained at our center for postoperative surveillance.
2 FAI 8 Secondary adrenal insufficiency ADE 33 182 MER 36 124 Adrenal adenoma TUR 1377 1258 ORT 1145 1068 Mean [+ or -] SD 973 [+ or -] 266 (n = 10) Range 568-1377
Cushing disease MON 411 4389 LAN 372 3925 Ectopic ACTH secretion BRE 9865 MOR 1574 IMO 786 Mean [+ or -] SD 2959 [+ or -] 3874 (n = 5) Range 786-9865
Cushing disease under OP'DDD MON 282 Ectopic ACTH under OP'DDD BRE 569 MOR 358 Chronic renal insufficiency Mean [+ or -] SD 387 [+ or -] 98 (n = 10) Range 265-568 11-HSD deficiency GON J-C 215 GON A 193 GON A (c) 146 Serum E, nmol/L [t.
Two of the patients had primary adrenal insufficiency (Addison disease), two had secondary adrenal insufficiency (hypopituitarism),10 had adrenal adenoma, two had
Cushing disease, five had ectopic ACTH secretion, 10 were hypertensive patients with CRI, and two were cases of 11[beta]-OH steroid dehydrogenase deficiency (AME-1).
