Clinical and biochemical manifestations of Cushing’s

Ntali, Georgia; Grossman, Ashley; Karavitaki, Niki

doi:10.1007/s11102-014-0631-4

Cited by 23 publications

(21 citation statements)

References 94 publications

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“…Cushing's disease is a rare disorder defined as chronic hypercortisolism due to a corticotropin-secreting pituitary tumor (corticotroph tumor) (1). Chronic cortisol excess is responsible for multisystem morbidity, contributing to increased mortality and altered quality of life (2,3).…”

Section: Introductionmentioning

confidence: 99%

SST5 expression and USP8 mutation in functioning and silent corticotroph pituitary tumors

Castellnou

Vasiljevic

Lapras

et al. 2020

Endocrine Connections

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Objective Somatostatin receptor type 5 (SST5) is inconsistently expressed by corticotroph tumors, with higher expression found in corticotropinomas having ubiquitin-specific protease 8 (USP8) mutations. Aims were to study the correlation between characteristics of corticotropinomas and SST5 expression/USP8 mutation status and to describe the response to pasireotide in five patients. Design Retrospective cohort study. Methods Clinico-biochemical, radiological and pathological data of 62 patients, operated for a functioning or silent corticotropinoma between 2013 and 2017, were collected. SST5 expression was measured by immunohistochemistry (clone UMB-4, Abcam, IRS > 1 being considered positive), and Sanger sequencing was performed on 50 tumors to screen for USP8 mutations. Results SST5 expression was positive in 26/62 pituitary tumors. A moderate or strong IRS was found in 15/58 corticotropinomas and in 13/35 functioning corticotropinomas. Among functioning tumors, those expressing SST5 were more frequent in women (22/24 vs 9/15, P = 0.04) and had a lower grade (P = 0.04) compared to others. USP8 mutations were identified in 13/50 pituitary tumors and were more frequent in functioning compared to silent tumors (11/30 vs 2/20, P = 0.05). SST5 expression was more frequent in USP8mut vs USP8wt tumors (10/11 vs 7/19, P = 0.007). Among treated patients, normal urinary free cortisol levels were obtained in three patients (IRS 0, 2 and 6), while a four-fold decrease was observed in one patient (IRS 4). Conclusion SST5 expression appears to be associated with functioning, USP8mut and lower grade corticotropinomas. A correlation between SST5 expression or USP8mut and response to pasireotide remains to be confirmed.

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Section: Introductionmentioning

confidence: 99%

SST5 expression and USP8 mutation in functioning and silent corticotroph pituitary tumors

Castellnou

Vasiljevic

Lapras

et al. 2020

Endocrine Connections

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“…Hypothyroidism can alter lipoprotein lipase activity, affecting lipid clearance and contributing to hyperlipidemia as well as increasing serum concentrations of leptin, a pro‐inflammatory and immune‐modulating adipokine in dogs and humans . Hypercortisolemia also alters lipid mobilization and metabolism and can result in increased plasma CHOL and TG concentrations in a variety of mammalian species . Although hypercortisolemia has not been well documented in rabbits with hyperadrenocorticism (due to lack of standardized RIs and testing protocols), both cortisol and corticosterone were shown to increase experimentally in rabbits with social stress, such that the stress of disease could have contributed to hyperlipidemia in the rabbits of our study.…”

Section: Discussionmentioning

confidence: 99%

Hypercholesterolemia and hypertriglyceridemia as biochemical markers of disease in companion rabbits

SHARMA

Hill

Christopher

2018

Veterinary Clinical Pathol

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Background: Inflammation has important effects on lipid metabolism, but the relationship between hyperlipidemia, inflammation, and disease remains unknown in rabbits. While rabbits are sensitive to dietary hypercholesterolemia, the etiology of hyperlipidemia when fed non-atherogenic diets is uncertain. Objectives:This study aimed to determine the association between hypercholesterolemia and patient characteristics, diseases, and select CBC and biochemistry analytes in rabbits, and to measure plasma lipoprotein lipid fractions in rabbits with inflammatory and other diseases. Methods:Complete blood count and plasma biochemistry data, including total cholesterol concentrations, were evaluated in 531 companion rabbits. Lipoprotein cholesterol fractions (non-high-density lipoprotein cholesterol [non-HDLc] and highdensity lipoprotein [HDLc]) and triglycerides were measured using a colorimetric enzymatic assay in archived plasma from a subset of 267 rabbits. Rabbits were categorized by age, sex, spay/neuter status, breed, diet status (fed atherogenic dietary components or not), the organ system affected by disease, and the pathologic process.Results: Cholesterol was associated with fibrinogen (P = 0.01), globulins (P < 0.01), and heterophil (P < 0.01) concentrations. Adjusting for diet, rabbits with severe infection or sepsis (odds ratio [OR] = 13.25, 95% CI = 5.83-30.12), renal failure (OR = 14.42, 95% CI = 5.69-36.54), and hepatopathy (OR = 8.55, 95% CI = 3.55-20.62) had increased risks of hypercholesterolemia. Increased non-HDLc and triglyceride concentrations were also associated with these three disease states (P < 0.05). Conclusions:Hyperlipidemia is associated with biochemical and CBC markers of inflammation, and with severe infection or sepsis, renal failure, and hepatopathy. Independent of diet, increased cholesterol, non-HDLc, and triglycerides are indicators of disease in companion rabbits. K E Y W O R D Shepatopathy, hyperlipidemia, lipoprotein, renal failure, sepsis

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“…Hypercortisolaemia induces lymphopaenia, cellular immune deficiency, and reduced number and function of CD4 cells. It also results also in inhibition of nuclear factor-kappa B, interfering with the production of cytokines that play an integral role in the immune response to bacterial infections 7. The degree of hypercortisolaemia in ectopic ACTH-related Cushing’s syndrome is far higher than that in pituitary-dependent Cushing’s disease and thus increases the extent of immunological impairment and risk of infection 8 9.…”

Section: Discussionmentioning

confidence: 99%

Ectopic ACTH syndrome complicated by multiple opportunistic infections treated with percutaneous ablation of the adrenal glands

Chan¹,

Roberts

2017

BMJ Case Reports

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Ectopic adrenocorticotropic hormone (ACTH)-related Cushing's syndrome can lead to multiple complications including severe immunosuppression. If the ACTH-secreting tumour cannot be found, definitive treatment is surgical adrenalectomy, typically followed by glucocorticoid replacement. Here, we present a case of fulminant respiratory failure secondary to coinfection with and cytomegalovirus in a patient with ectopic ACTH-dependent Cushing's syndrome with occult primary. Due to significant deconditioning, she was unable to undergo definitive adrenalectomy and instead underwent percutaneous microwave ablation of the adrenal glands.

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Clinical and biochemical manifestations of Cushing’s

Cited by 23 publications

References 94 publications

SST5 expression and USP8 mutation in functioning and silent corticotroph pituitary tumors

SST5 expression and USP8 mutation in functioning and silent corticotroph pituitary tumors

Hypercholesterolemia and hypertriglyceridemia as biochemical markers of disease in companion rabbits

Ectopic ACTH syndrome complicated by multiple opportunistic infections treated with percutaneous ablation of the adrenal glands

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