<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Introduction Cushing’s disease is a rare endocrine disorder characterized by persistent hypercortisolism due to excessive, autonomous ACTH secretion by a pituitary adenoma. Transsphenoidal adenomectomy is the main therapeutic option in Cushing’s disease. When imaging studies are unable to demonstrate an obvious pituitary mass complete tumor resection is difficult and often encumbered by risk of relapse. Medical therapy is a second-line option or the first-line treatment for patients with high surgical risk, incomplete surgical resection or relapse. Rarely classic clinical manifestations limit the selection of medical therapy for Cushing’s disease. Case presentation We present the case of a male patient with Cushing’s disease complicated with diabetes mellitus and severe hepatocytolisis syndrome with no visible pituitary adenoma on MRI studies. In the absence of technical equipment petrosal sinus sampling could not be performed in order to improve surgery outcome </p><p>Conclusion The presence of unbalanced diabetes and severe hepatocytolisis syndrome made it impossible to use steroidogenesis inhibitors (mitotane, ketoconazole, metyrapone, etomidate) or inhibitors of ACTH secretion as pasireotide that represent a new option in achieving control of hypercortisolism </p></abstract>

Introduction Cushing’s disease is a rare endocrine disorder characterized by persistent hypercortisolism due to excessive, autonomous ACTH secretion by a pituitary adenoma. Transsphenoidal adenomectomy is the main therapeutic option in Cushing’s disease. When imaging studies are unable to demonstrate an obvious pituitary mass complete tumor resection is difficult and often encumbered by risk of relapse. Medical therapy is a second-line option or the first-line treatment for patients with high surgical risk, incomplete surgical resection or relapse. Rarely classic clinical manifestations limit the selection of medical therapy for Cushing’s disease. Case presentation We present the case of a male patient with Cushing’s disease complicated with diabetes mellitus and severe hepatocytolisis syndrome with no visible pituitary adenoma on MRI studies. In the absence of technical equipment petrosal sinus sampling could not be performed in order to improve surgery outcome Conclusion The presence of unbalanced diabetes and severe hepatocytolisis syndrome made it impossible to use steroidogenesis inhibitors (mitotane, ketoconazole, metyrapone, etomidate) or inhibitors of ACTH secretion as pasireotide that represent a new option in achieving control of hypercortisolism

Severe hepatocytolisis syndrome - a challenge in medical therapy of Cushing’s disease

Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

Department of Endocrinology, Clinical County Hospital, Cluj-Napoca, Romania

Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania & C.I.Parhon National Institute of Endocrinology, Bucharest, Romania

Department of Radiotherapy, Prof. Dr. Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania

ARS Medica Tomitana

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction Cushing’s disease is a rare endocrine disorder characterized by persistent hypercortisolism due to excessive, autonomous ACTH secretion by a...

Severe hepatocytolisis syndrome - a challenge in medical therapy of Cushing’s disease

Publicado en línea: 25 ago 2015

Páginas: 132 - 136

DOI: https://doi.org/10.1515/arsm-2015-0034

Palabras clave
Cushing’s disease, hepatic cytolysis, pasireotide

© by Ana Valea

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Severe hepatocytolisis syndrome - a challenge in medical therapy of Cushing’s disease

Publicado en línea: 25 ago 2015

Páginas: 132 - 136

DOI: https://doi.org/10.1515/arsm-2015-0034

Palabras claveCushing’s disease, hepatic cytolysis, pasireotide

© by Ana Valea

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Palabras clave
Cushing’s disease, hepatic cytolysis, pasireotide