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Cited by 84Adrenal and Paraganglionic TumorsPituitary Gland Disorders and TreatmentsAdrenal Hormones and Disorders

“Subclinical Cushing’s syndrome” is not subclinical: improvement after adrenalectomy in 9 patients

Mitchell, Ian C., Auchus, Richard J., Juneja, Kavita, Chang, Alice Y., Holt, Shelby A., Snyder, William H., Nwariaku, Fiemu E.·2007·Surgery
DOI 10.1016/j.surg.2007.10.001
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Abstract

Background A subgroup of patients with adrenal cortisol hypersecretion fails to meet the biochemical criteria for Cushing's syndrome. Appropriate therapy for this entity, subclinical Cushing's syndrome (subclinical CS), is unclear. We examined outcomes for patients who underwent unilateral adrenalectomy for subclinical CS. Methods Between 2003 and 2006, all patients who underwent adrenalectomy for cortisol hypersecretion caused by an adrenal mass were examined. We analyzed biochemical, metabolic, and clinical outcomes. Results Overall, 24 patients underwent adrenalectomy for adrenal cortisol hypersecretion, of which 9 were found to have subclinical CS. Median serum cortisol was 2.0 microg/dL (range, 1.1-6.1) after 1-mg overnight dexamethasone suppression testing. Suspicious clinical findings on preoperative examination included skin bruising, unexplained weight gain, proximal muscle weakness, abnormal fat pads, skin thinning, fatigue, and facial plethora. During a median follow-up period of 5 months (range, 1-30 months), all 8 patients with easy bruising noted resolution postoperatively. Fatigue improved in 4 of 5 patients, muscle weakness in 6 of 8 patients, and weight in 7 of 9 patients, with a median body mass index change of -2.0 kg/m(2) (range, -7.1 to +0.5 kg/m(2)). Conclusion Adrenalectomy improves clinical and metabolic parameters for many patients with subclinical CS.

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  • Several small studies suggested improvement of blood pressure, glucose metabolism, and body weight in surgically treated subclinical hypercortisolism patients.

    “Several small studies suggested the improvement of blood pressure (54, 93, 95), glucose metabolism (46,54,93,95), and body weight (54,95) in surgically treated SH patients.”

    From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [95]

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Authors
Mitchell, I. C., Auchus, R. J., Juneja, K., Chang, A. Y., Holt, S. A., Snyder, W. H., & Nwariaku, F. E.
Affiliations
The University of Texas Southwestern Medical Center (US)
Corresponding author
Nwariaku, Fiemu E.
ORCID
Venue
Surgery
Publisher
Elsevier BV
Published
2007-12
Volume
142
Issue
6
Pages
900-905.e1
ISSN
0039-6060 (ISSN-L)
DOI
10.1016/j.surg.2007.10.001
OpenAlex
W2018513451
Cited by
84
References
30
Citations by year
2024: 1 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 5 · 2015: 2 · 2014: 11 · 2013: 3 · 2012: 8
FWCI
7.28
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
subclinical Cushing's syndrome, unilateral adrenalectomy, adrenal mass, dexamethasone suppression test, easy bruising, fatigue, muscle weakness, weight gain, body mass index, postoperative outcomes
MeSH terms
Adenoma, Adrenal Cortex, Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aged, Aged, 80 and over, Cushing Syndrome, Female, Humans, Hydrocortisone, Hyperplasia, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Treatment Outcome

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