Ketoconazole in the management of paraneoplastic Cushing's syndrome secondary to ectopic adrenocorticotropin production.

Winquist, Eric; Laskey, Jennifer; Crump, M.; Khamsi, Firouz; Shepherd, Frances A.

doi:10.1200/jco.1995.13.1.157

Cited by 93 publications

(47 citation statements)

References 28 publications

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“…11-␤-hydroxylase is the enzyme responsible for the hydroxylation of 11-deoxycortisol to cortisol while desmolase converts cholesterol to ı-5-pregnenolone [13][14][15]. Only a few reports about the usefulness of glucosteroid biosynthesis inhibitors in ectopic ACTH syndrome are published, and they report controversial results [16][17][18][19][20]. In the study of Winquist et al, the conclusions were that ketoconazole did not prolong survival, but it did provide a palliative hormonal response in two third of patients.…”

Section: Discussionmentioning

confidence: 99%

A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

et al. 2006

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Summary Secretion of ectopic adrenocorticotropic hormone (ACTH) with consequently Cushing's syndrome is a rare paraneoplastic phenomenon. It has been described in a variety of malignancies, like bronchial carcinoids, small-cell lung carcinoma, thymoma, pancreatic carcinoma and other. In many cases of suspected ectopic ACTH secretion, it is difficult to histologically or cytochemically confirm the diagnosis. We present a 63-year-old woman with a recurrent poorly differentiated squamous cell lung carcinoma with clinical and biochemical features consistent with ectopic Cushing's syndrome. Immunocytochemical staining confirmed the secretion of ACTH by tumour cells.

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Section: Discussionmentioning

confidence: 99%

A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

et al. 2006

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“…However, there have been few published studies on its utility in ectopic Cushing's syndrome, and the results have been controversial. Winquist et al (13) conclude that ketoconazole does not prolong survival but promotes a palliative hormonal response in 2/3 of patients. In our patient, ketoconazole at 900 mg/day resolved the hypokalemia, reduced the hypercortisolism and improved the psychotic symptoms.…”

Section: Discussionmentioning

confidence: 99%

Severe hypertension and hypokalemia as first clinical manifestations in ectopic Cushing's syndrome

Fernández-Rodríguez¹,

Villar-Taibo²,

Pinal-Osorio³

et al. 2008

Arq Bras Endocrinol Metab

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Ectopic ActH production occurs in about 10% of all cases of cushing's syndrome, and about 25% of cases of ActH-dependent cushing's syndrome. diverse tumor types are able to produce ActH ectopically, including small cell lung carcinoma. Ectopic ActH secretion by malignant neoplasm has been reported to have earlier and more aggressive metabolic effects. We report a 59-year-old male patient with severe hypertension, metabolic alkalosis and hypokalemia as the first clinical manifestations of an ActH-secreting small cell lung carcinoma, although the typical phenotypic features of cushing's syndrome were not present. Ectopic cushing's syndrome should always be ruled out in patients with severe hypertension and hypokalemia.

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“…A redução da produção de cortisol com cetoconazol oral tem sido relatada por vários autores (44,45). Uma vantagem sobre outras alternativas terapêuticas é a pequena incidência de efeitos colaterais que ocasiona.…”

Section: Associação Cetoconazol E Octreotide No Tratamento Do Hipercounclassified

Papel da terapia medicamentosa na síndrome de Cushing

Liberman

2003

Arq Bras Endocrinol Metab

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A terapêutica cirúrgica continua, até o momento, a ser considerada a principal, para a síndrome de Cushing endógena, qualquer que seja a causa. Entretanto em certas circunstâncias, como preparo pré-cirúrgico, ausência de cura após a cirurgia ou impossibilidade cirúrgica, a terapêutica medicamentosa tem papel importante. As drogas que inibem a esteroidogênese, como mitotane, metirapona, cetoconazol e aminoglutetimida são as drogas de escolha qualquer que seja a causa da síndrome de Cushing. Cetoconazol constitui-se em nosso meio na droga de escolha entre os inibidores da síntese de cortisol. É uma medicação que pode ser usada a longo prazo e freqüentemente não ocasiona efeitos colaterais importantes. Os chamados neuromoduladores, como ciproheptadina, bromocriptina e ácido valpróico em nossa experiência tem pouco efeito na doença de Cushing. Somatostatina de ação prolongada como Sandostatin e Sandostatin-LAR podem ter papel importante na terapêutica da síndrome de secreção ectópica de ACTH/CRH. Quimioterapia e radioterapia têm indicações especificas nas diversas causas da síndrome de Cushing.

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Ketoconazole in the management of paraneoplastic Cushing's syndrome secondary to ectopic adrenocorticotropin production.

Cited by 93 publications

References 28 publications

A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

Severe hypertension and hypokalemia as first clinical manifestations in ectopic Cushing's syndrome

Papel da terapia medicamentosa na síndrome de Cushing

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