Effects of ketoconazole treatment on hormone secretion in metastatic adrenal carcinoma

Lorè, F; Cairano, G. Di; Nobili, Mauro; Marchetti, Fabio; Manasse, G; Romei, M.

doi:10.1016/0277-5379(86)90259-2

Cited by 1 publication

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“…In contrast to the well known effects of tional adrenal gland neoplasms are scarce. We are aware of only six reports where ketoconazole was used to inhibit adrenal tumoural steroidogenesis, all of them in patients with Cushing's syndrome secondary to adrenal carcinoma or adenoma (12)(13)(14)17,18). Our patient seems unique owing to the fact that there were no clinical signs of Cush¬ ing's disease and that cortisol levels were relatively low compared with testosterone levels.…”

Section: Discussionmentioning

confidence: 93%

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Use of ketoconazole in the treatment of a virilizing adrenocortical carcinoma

Verhelst

Druwé²,

Erps³

et al. 1989

Acta Endocrinologica

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Ketoconazole, an oral antimycotic agent, is known to have a potent inhibitory effect on adrenal steroid production. It was given at a dose of 1200 mg/day to a 52-year-old female patient with a virilizing adrenocortical carcinoma in order to achieve better metabolic control pre-operatively. Together with a rapid normalisation of hypertension and hyperglycemia, a dramatic fall was noticed in serum and urinary adrenal steroids after a few days. Levels of total testosterone (20 nmol/l), androstenedione (>35 nmol/l) and DHEA-sulphate (>28 nmol/l) fell to normal levels in 6 days. By contrast, levels of 17-OH\x=req-\ progesterone (30 nmol/l) and progesterone (2.45 nmol/l) increased slightly, indicating inhibition af adrenal 17, 20\ x=req-\ lyase. Cortisol (620 nmol/l at 08.00 h) fell to very low levels (50 nmol/l) on day 6 of the trial. We conclude that ketoconazole is very effective in suppression of adrenal tumoural steroidogenesis and merits consideration in pre-operative use. We warn against dangerous hypoadrenalism which seems to occur earlier in tumoural than in normal adrenal metabolism.

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Section: Discussionmentioning

confidence: 93%

“…From a clinical perspective, ketoconazole has been used with success in patients with Cushing's syndrome secondary to metastatic adrenal carci¬ noma when chemotherapy (o,p'-DDD) was not available (13,14,18).…”

Section: Discussionmentioning

confidence: 99%