Cushing's syndrome: Consequences of late diagnosis after bariatric surgery

Prior to bariatric surgery, endocrine causes of obesity must be excluded. The diagnosis of osteoporosis in a male requires the study of secondary causes of this condition. The diagnostic delay of Cushing's syndrome may have irreversible consequences. AbstractPrior to bariatric surgery, endocrine causes of obesity must be excluded. The diagnosis of osteoporosis in a male requires the study of secondary causes of this condition. The diagnostic delay of Cushing's syndrome may have irreversible consequences.
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research

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os C, Scaroni C, Valassi E, van der Werff SJA, Schopohl J, Beuschlein F, Reincke M Abstract CONTEXT: Signs and symptoms of Cushing's syndrome (CS) overlap with common diseases, such as the metabolic syndrome, obesity, osteoporosis, and depression. Therefore, it can take years to finally diagnose CS, though early diagnosis is important for prevention of complications. OBJECTIVE: The aim of this study was to assess the time span between first symptoms and diagnosis of CS in different populations in order to identify factors associated with an early diagnosis. DATA SOURCES: A systematic literature search vi...
Source: The Journal of Clinical Endocrinology and Metabolism - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
Purpose of review Adrenal tumors occur in 5% of population with higher prevalence in elderly. Patients with adrenal tumors present with overt hormonal excess in up to 15% of cases, and mild autonomous cortisol secretion in 30–40% of cases. Overt Cushing syndrome, mild autonomous cortisol secretion, pheochromocytoma, and primary aldosteronism have been associated with higher cardiovascular morbidity and mortality. Increasing experimental and clinical evidence also suggests that adrenal hormone excess is detrimental to bone health. This review aims to discuss the effect of cortisol, aldosterone, and catecholamine exc...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research
Abstract "Subclinical hypercortisolism" (SH) refers to a condition associated with a mild chronic increase in cortisol secretion. By definition, patients with SH do not exhibit specific symptoms of overt Cushing's syndrome (such as purple striae, easy bruising, proximal muscle weakness), SH has been preferred to "subclinical Cushing's syndrome", a semantic ambiguity since Cushing's syndrome is, by definition, a set of symptoms; and to the term "preclinical Cushing syndrome" because the progression toward overt clinical hypercortisolism is very rare. However, SH still is misnomer as a ...
Source: Annales d'Endocrinologie - Category: Endocrinology Authors: Tags: Ann Endocrinol (Paris) Source Type: research
Authors: Chiodini I, Morelli V Abstract Subclinical hypercortisolism (SH) is a condition of mild cortisol excess, found in the 5-30% of patients with adrenal incidentalomas, defined as silent adrenal masses diagnosed throughout radiological examinations performed for unrelated diseases. Generally, the diagnosis of SH is supported by the presence of high cortisol levels after a 1-mg dexamethasone suppression test, low adrenocorticotropic hormone levels, altered cortisol circadian rhythm and 24-hour urinary free cortisol levels higher than the upper reference value. Less frequently, diagnosis is made by other tests. ...
Source: Frontiers of Hormone Research - Category: Endocrinology Tags: Front Horm Res Source Type: research
Authors: Debono M, Newell-Price JD Abstract The diagnosis of Cushing's syndrome is challenging to endocrinologists as patients often present with an insidious history, together with subtle external clinical features. Moreover, complications of endogenous hypercortisolism, such as visceral obesity, diabetes, hypertension and osteoporosis, are conditions commonly found in the population, and discerning whether these are truly a consequence of hypercortisolism is not straightforward. To avoid misdiagnosis, a careful investigative approach is essential. The investigation of Cushing's syndrome is a three-step process. F...
Source: Frontiers of Hormone Research - Category: Endocrinology Tags: Front Horm Res Source Type: research
Publication date: Available online 10 May 2016 Source:The Lancet Diabetes & Endocrinology Author(s): Rosario Pivonello, Andrea M Isidori, Maria Cristina De Martino, John Newell-Price, Beverly M K Biller, Annamaria Colao Cushing's syndrome is a serious endocrine disease caused by chronic, autonomous, and excessive secretion of cortisol. The syndrome is associated with increased mortality and impaired quality of life because of the occurrence of comorbidities. These clinical complications include metabolic syndrome, consisting of systemic arterial hypertension, visceral obesity, impairment of glucose metabolism, ...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
CONCLUSIONS: Skeletal muscle 11β-HSD1 is up-regulated with age in women and is associated with reduced grip strength, insulin resistance, and an adverse body composition profile. Selective inhibition of 11β-HSD1 may offer a novel strategy to prevent and/or reverse age-related sarcopenia. PMID: 25989394 [PubMed - as supplied by publisher]
Source: Diabetes Metab - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
Purpose of review: The article aims to update the reader on current developments in the area of adrenal incidentaloma complicated by subclinical hypercortisolism. We will discuss different diagnostic strategies and complications associated with this disease, and address the conflicting opinions related to the treatment of these patients. Recent findings: Depending on diagnostic criteria used, between 30 and 50% of patients with adrenocortical incidentaloma have biochemical hypercortisolism, but lack classical external features of Cushing's syndrome. The challenge facing the clinician is that in the sixth and seventh decade...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Anand Vaidya Source Type: research
We present an update on protein kinase A (PKA) defects and Cushing syndrome. Recent findings: The cyclic AMP-dependent PKA catalytic subunit alpha (PRKACA) hotspot point mutation (c.617A > C [p.Leu206Arg]), leading to an increase of basal PKA activity, and formation of cortisol-producing adenoma has been frequently shown to cause the most common form of adrenocorticotropic hormone-independent Cushing syndrome. Summary: Somatic PRKACA mutations have been found in up to 50% of patients with adrenal adenomas. Germline PRKACA amplification was also seen in bilateral adrenal hyperplasias. PRKACA activation was associated...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Anand Vaidya Source Type: research
CONCLUSION: Laparoscopic adrenalectomy seems to be beneficial in reversing several metabolic effects of hypercortisolism, with a low morbidity rate. However, the heterogeneity and low quality of the available studies preclude definitive recommendations. PMID: 25640696 [PubMed - as supplied by publisher]
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
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