Pharmacological Therapy of Cushings Syndrome: Drugs and Indications

Díez, Juan J.; Iglesias, Pedro

doi:10.2174/138955707780619653

Cited by 34 publications

(32 citation statements)

References 194 publications

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“…The patient developed acute exacerbation of IPF shortly after his hypercortisolemia was controlled using oral metyrapone, an adrenal steroidogenesis inhibitor (7,8). Previous studies have suggested a possible role of surgical pulmonary procedures, bronchoscopy, or radiation therapy for lung cancer in the onset of acute exacerbation of IPF (9-12).…”

Section: Discussionmentioning

confidence: 99%

Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome

et al. 2016

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A 64-year-old Japanese man with mild reticular shadows in both lungs developed a lung tumor causing ectopic Cushing's syndrome. He was prescribed an adrenal inhibitor, which controlled his hypercortisolemia. However, he developed acute exacerbation of idiopathic pulmonary fibrosis (IPF) and died within weeks. Previous studies have suggested a dosage reduction of corticosteroids for IPF as a triggering event for acute exacerbation. The present case suggests that IPF coexisting with Cushing's syndrome may have been exacerbated after the correction of hypercortisolemia. Therefore, close monitoring of cortisol levels along with the clinical course of IPF is required in similar cases that require the correction of hypercortisolemia.

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Section: Discussionmentioning

confidence: 99%

Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome

et al. 2016

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“…Metyrapone is an orphan medication that holds the FDA approval for the diagnosis of Cushing's syndrome and is occasionally used off-label for short-term treatment of Cushing's syndrome before surgery. However, treatment with metyrapone or other steroidogenic inhibitors is usually discouraged because of poor tolerability and the contradictory increase in ACTH production and mineralocorticoid effects (Díez and Iglesias, 2007;Traina et al, 2013). Therefore, alternative medical treatments for the curtailing of HPA-axis activity are needed.…”

Section: Po0mentioning

confidence: 99%

The Vasopressin 1b Receptor Antagonist A-988315 Blocks Stress Effects on the Retrieval of Object-Recognition Memory

Barsegyan

Atsak

Hornberger

et al. 2015

Neuropsychopharmacol

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Stress-induced activation of the hypothalamo-pituitary-adrenocortical (HPA) axis and high circulating glucocorticoid levels are well known to impair the retrieval of memory. Vasopressin can activate the HPA axis by stimulating vasopressin 1b (V1b) receptors located on the pituitary. In the present study, we investigated the effect of A-988315, a selective and highly potent non-peptidergic V1b-receptor antagonist with good pharmacokinetic properties, in blocking stress effects on HPA-axis activity and memory retrieval. To study cognitive performance, male Sprague-Dawley rats were trained on an object-discrimination task during which they could freely explore two identical objects. Memory for the objects and their location was tested 24 h later. A-988315 (20 or 60 mg/kg) or water was administered orally 90 min before retention testing, followed 60 min later by stress of footshock exposure. A-988315 dose-dependently dampened stressinduced increases in corticosterone plasma levels, but did not significantly alter HPA-axis activity of non-stressed control rats. Most importantly, A-988315 administration prevented stress-induced impairment of memory retrieval on both the object-recognition and the object-location tasks. A-988315 did not alter the retention of non-stressed rats and did not influence the total time spent exploring the objects or experimental context in either stressed or non-stressed rats. Thus, these findings indicate that direct antagonism of V1b receptors is an effective treatment to block stress-induced activation of the HPA axis and the consequent impairment of retrieval of different aspects of recognition memory.

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“…A gyógyszer hatása a vizeletkortizol-ürítéssel nyomon követhető. A betegek mintegy 15%-ában a máj-enzimek szérumszintje jelentősen növekedhet, amelyet betegünknél nem tapasztaltunk [8,10].…”

Section: Megbeszélésunclassified

A rare form of adrenal Cushing’s syndrome

et al. 2013

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A szerzők coarctatio aortae miatt gondozott 74 éves beteg esetét ismertetik, akinél a kifejezett hypokalaemia hát-terében bilateralis macronodularis mellékvesekéreg-hyperplasia okozta Cushing-szindróma igazolódott. Esetükben e két ritka kórkép együttesen fordult elő. Cardialis statusára tekintettel -a fokozott műtéti kockázat miatt -szteroid bioszintézisgátló kezelés mellett döntöttek, amelynek hatására a hypercortisolismus fi zikális és biokémiai jelei regressziót mutattak. Később, a coarctatio intervenciós radiológiai megoldását követően állapota, cardialis statusa is lényegesen javult. Esetükben e ritka fejlődési rendellenesség megoldása még későbbi életkorban is eredménnyel járt. A szerzők ismerete szerint a két ritka betegség együttes előfordulását még nem közölték az irodalomban. Orv. Hetil., 2013, 154(50), 1999-2002 Kulcsszavak: bilateralis macronodularis mellékvesekéreg-hyperplasia, coarctatio aortae, Cushing-szindróma A rare form of adrenal Cushing's syndromeThe authors present the case history of a 74-year-old male suffering from aortic coarctation. His endocrine evaluation was initiated because of severe hypokalemia. The diagnostic procedures revealed the presence of Cushing's syndrome caused by bilateral macronodular adrenal hyperplasia. Because of the high risk of surgical treatment due to his cardiac condition, the patient was treated with the steroid biosynthesis inhibitor ketoconazole, which resulted in a clinical and biochemical regression of hypercortisolism. After interventional treatment of the aortic coarctation the physical and cardiac condition of the patient showed a signifi cant improvement, indicating that despite an old age, surgery offered a valuable tool for management of the disease. To the best knowledge of the authors, the coexistence of aortic coarctation and bilateral macronodular adrenal hyperplasia has not been previously reported.Keywords: bilateral macronodular adrenal hyperplasia, aortic coarctation, Cushing's syndrome Sohár, G., Szücs, N., Racz, K., Merkely, B., Hüttl, K., Sármán, P., Györkös, A., Gasztonyi, B. (2013). [A rare form of adrenal Cushing's syndrome]. Orv. Hetil., 154(50), 1999Hetil., 154(50), -2002 (Beérkezett: 2013. október 14.; elfogadva: 2013. október 31.) Rövidítések ACE = angiotenzinkonvertáló enzim; ACTH = adrenokortikotrop hormon; EF = ejekciós frakció; FSH = folliculusstimuláló hormon; HU = Hounsfi eld-egység; ICD = implantálható cardioverter defi brillátor; ISZB = ischaemiás szívbetegség; LAD = bal elülső leszálló ág; LH = luteinizáló hormon; nsVT = non sustained kamrai tachycardia; OM = obtus marginalis; PCI = percutan coronariaintervenció; PRA = plazmarenin-aktivitás; RDA = jobb leszálló ág Coarctatiónak nevezzük az aortaisthmus területén kialakult szűkületet. A coarctatio aortae a congenitalis cardialis laesiók mintegy 5%-át teszi ki [1]. Egyszerű coarctatióról akkor beszélünk, ha a szűkület izoláltan fordul elő. Ez a leggyakoribb forma, amelynek felismerésére gyakran csak felnőttkorban kerül sor [1,2]. Tí-pusos tünetei a felső testfélen mért hyp...

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Pharmacological Therapy of Cushings Syndrome: Drugs and Indications

Cited by 34 publications

References 194 publications

Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome

Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome

The Vasopressin 1b Receptor Antagonist A-988315 Blocks Stress Effects on the Retrieval of Object-Recognition Memory

A rare form of adrenal Cushing’s syndrome

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