Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Spontaneous Remission in Cushing's Disease

Spontaneous Remission in Cushing's Disease Abstract Two patients with Cushing's disease underwent spontaneous clinical and biochemical remission following a period of secondary adrenal insufficiency. One of the patients was untreated, while the other had been treated with partial bilateral adrenalectomy before. Both patients underwent remission shortly after the administration of dexamethasone for diagnostic purposes and remained symptom free for 2 and 3 years, respectively, which was followed by relapse of the disease. We conclude that although resolution of Cushing's disease may occur spontaneously, probably by hemorrhagic infarction of corticotroph microadenomas, careful follow-up studies are required since the relapse of the disease occurs later in some patients. (Arch Intern Med. 1993;153:251-255) References 1. Pasqualini RQ, Gurevich N. Spontaneous remission in a case of Cushing's syndrome . J Clin Endocrinol Metab. 1956;16:406-411.Crossref 2. Hayslett JP, Cohn GL. Spontaneous remission of Cushing's disease . N Engl J Med. 1967;276: 968-970.Crossref 3. Givens JR, Camacho A, Patterson P. Effect of aminoglutethimide and reserpine on the human pituitary-adrenal axis: remission of a case of Cushing's disease . Metabolism. 1970;19:818-830.Crossref 4. Kaplan NM, Shires GT. Apparent cure of Cushing's disease by bilateral adrenalectomy and autotransplantation . Am J Med. 1972;53:377-380.Crossref 5. Putnam TI, Aceto T, Abbassi V, Kenny FM. Cushing's disease with a spontaneous remission . Pediatrics. 1972;50:477-481. 6. Kammer H, Barter M. Spontaneous remission of Cushing's disease . Am J Med. 1979;67:519-523.Crossref 7. Grant DB, Atherden SM. Cushing's disease presenting with growth failure: clinical remission during cyproheptadine therapy . Arch Dis Child. 1979; 54:466-468.Crossref 8. Scott RS, Espiner EA, Donald RA. Intermittent Cushing's disease with spontaneous remission . Clin Endocrinol. 1979;11:561-566.Crossref 9. Weisen M. Ross F, Krieger DT. Prolonged remission of a case of Cushing's disease following cessation of cyproheptadine therapy . Acta Endocrinol. 1983;102:436-438. 10. Couch RM, Smail PJ, Dean HJ, Winter JSD. Prolonged remission of Cushing's disease after treatment with cyproheptadine . J Pediatr. 1984;104: 906-908.Crossref 11. Dickstein GD, Spindel A, Shechner C, Adawi F, Gutman H. Spontaneous remission in Cushing's disease . Arch Intern Med. 1991;151:185-189.Crossref 12. Silber RH, Porter CC. The determination of 17,21-dihydroxy-20-ketosteroids in urine and plasma . J Biol Chem. 1954;210:923-932. 13. Yamaji T, Ishibashi M, Sekihara H, Itabashi A, Yanaihara T. Serum dehydroepiandrosterone sulfate in Cushing's syndrome . J Clin Endocrinol Metab. 1984;59:1164-1168.Crossref 14. Nugent CA, Nichols T, Tyler FH. Diagnosis of Cushing's syndrome: single dose dexamethasone suppression test . Arch Intern Med. 1965;116:172-176.Crossref 15. Wakai S, Fukushima T, Teramoto A, Sano K. Pituitary apoplexy: its incidence and clinical significance . J Neurosurg. 1981;55:187-193.Crossref 16. Findling JW, Tyrrell JB, Aron DC, Fitzgerald PA, Wilson CB, Forsham PH. Silent pituitary apoplexy: subclinical infarction of an adrenocorticotropin-producing pituitary adenoma . J Clin Endocrinol Metab. 1981;52:95-97.Crossref 17. Bjerre P, Lindholm J, Videbaek JH. The spontaneous course of pituitary adenomas and occurrence of an empty sella in untreated acromegaly . J Clin Endocrinol Metab. 1986;63:287-291.Crossref 18. Ishibashi M, Yamaji T. Direct effects of thyrotropinreleasing hormone, cyproheptadine, and dopamine on adrenocorticotropin secretion from human corticotroph adenoma cells in vitro . J Clin Invest. 1981;68:1018-1027.Crossref 19. Atkinson AB. McCance DR, Kennedy L, Sheridan B. Cyclical Cushing's syndrome first diagnosed after surgery: a trap for the unwary . Clin Endocrinol. 1992;36:297-300.Crossref 20. Werner PL, Shah JH, Kukreja SC, Miller SM, Williams GA. Recurrence of acromegaly after pituitary apoplexy . JAMA. 1982;247:2816-2818.Crossref 21. Hardy J. Cushing's disease: 50 years later . Can J Neurol Sci. 1982;9:375-380. 22. Boggan JE, Tyrrell JB, Wilson CB. Transsphenoidal microsurgical management of Cushing's disease: report of 100 cases . J Neurosurg. 1983; 59:195-200.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Spontaneous Remission in Cushing's Disease

Download PDF
5 pages

Loading next page...
 
/lp/american-medical-association/spontaneous-remission-in-cushing-s-disease-cBQFfKliYU

References (25)

Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1993.00410020097009
Publisher site
See Article on Publisher Site

Abstract

Abstract Two patients with Cushing's disease underwent spontaneous clinical and biochemical remission following a period of secondary adrenal insufficiency. One of the patients was untreated, while the other had been treated with partial bilateral adrenalectomy before. Both patients underwent remission shortly after the administration of dexamethasone for diagnostic purposes and remained symptom free for 2 and 3 years, respectively, which was followed by relapse of the disease. We conclude that although resolution of Cushing's disease may occur spontaneously, probably by hemorrhagic infarction of corticotroph microadenomas, careful follow-up studies are required since the relapse of the disease occurs later in some patients. (Arch Intern Med. 1993;153:251-255) References 1. Pasqualini RQ, Gurevich N. Spontaneous remission in a case of Cushing's syndrome . J Clin Endocrinol Metab. 1956;16:406-411.Crossref 2. Hayslett JP, Cohn GL. Spontaneous remission of Cushing's disease . N Engl J Med. 1967;276: 968-970.Crossref 3. Givens JR, Camacho A, Patterson P. Effect of aminoglutethimide and reserpine on the human pituitary-adrenal axis: remission of a case of Cushing's disease . Metabolism. 1970;19:818-830.Crossref 4. Kaplan NM, Shires GT. Apparent cure of Cushing's disease by bilateral adrenalectomy and autotransplantation . Am J Med. 1972;53:377-380.Crossref 5. Putnam TI, Aceto T, Abbassi V, Kenny FM. Cushing's disease with a spontaneous remission . Pediatrics. 1972;50:477-481. 6. Kammer H, Barter M. Spontaneous remission of Cushing's disease . Am J Med. 1979;67:519-523.Crossref 7. Grant DB, Atherden SM. Cushing's disease presenting with growth failure: clinical remission during cyproheptadine therapy . Arch Dis Child. 1979; 54:466-468.Crossref 8. Scott RS, Espiner EA, Donald RA. Intermittent Cushing's disease with spontaneous remission . Clin Endocrinol. 1979;11:561-566.Crossref 9. Weisen M. Ross F, Krieger DT. Prolonged remission of a case of Cushing's disease following cessation of cyproheptadine therapy . Acta Endocrinol. 1983;102:436-438. 10. Couch RM, Smail PJ, Dean HJ, Winter JSD. Prolonged remission of Cushing's disease after treatment with cyproheptadine . J Pediatr. 1984;104: 906-908.Crossref 11. Dickstein GD, Spindel A, Shechner C, Adawi F, Gutman H. Spontaneous remission in Cushing's disease . Arch Intern Med. 1991;151:185-189.Crossref 12. Silber RH, Porter CC. The determination of 17,21-dihydroxy-20-ketosteroids in urine and plasma . J Biol Chem. 1954;210:923-932. 13. Yamaji T, Ishibashi M, Sekihara H, Itabashi A, Yanaihara T. Serum dehydroepiandrosterone sulfate in Cushing's syndrome . J Clin Endocrinol Metab. 1984;59:1164-1168.Crossref 14. Nugent CA, Nichols T, Tyler FH. Diagnosis of Cushing's syndrome: single dose dexamethasone suppression test . Arch Intern Med. 1965;116:172-176.Crossref 15. Wakai S, Fukushima T, Teramoto A, Sano K. Pituitary apoplexy: its incidence and clinical significance . J Neurosurg. 1981;55:187-193.Crossref 16. Findling JW, Tyrrell JB, Aron DC, Fitzgerald PA, Wilson CB, Forsham PH. Silent pituitary apoplexy: subclinical infarction of an adrenocorticotropin-producing pituitary adenoma . J Clin Endocrinol Metab. 1981;52:95-97.Crossref 17. Bjerre P, Lindholm J, Videbaek JH. The spontaneous course of pituitary adenomas and occurrence of an empty sella in untreated acromegaly . J Clin Endocrinol Metab. 1986;63:287-291.Crossref 18. Ishibashi M, Yamaji T. Direct effects of thyrotropinreleasing hormone, cyproheptadine, and dopamine on adrenocorticotropin secretion from human corticotroph adenoma cells in vitro . J Clin Invest. 1981;68:1018-1027.Crossref 19. Atkinson AB. McCance DR, Kennedy L, Sheridan B. Cyclical Cushing's syndrome first diagnosed after surgery: a trap for the unwary . Clin Endocrinol. 1992;36:297-300.Crossref 20. Werner PL, Shah JH, Kukreja SC, Miller SM, Williams GA. Recurrence of acromegaly after pituitary apoplexy . JAMA. 1982;247:2816-2818.Crossref 21. Hardy J. Cushing's disease: 50 years later . Can J Neurol Sci. 1982;9:375-380. 22. Boggan JE, Tyrrell JB, Wilson CB. Transsphenoidal microsurgical management of Cushing's disease: report of 100 cases . J Neurosurg. 1983; 59:195-200.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Jan 25, 1993

There are no references for this article.