Diagnosis and Multimodality Management of Cushing's Disease: A Practical Review.
Diagnosis and Multimodality Management of Cushing's Disease: A Practical Review.
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DOI：
10.1155/2013/893781
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发表时间：
2013
影响因子：
2.8
通讯作者：
Zada G
中科院分区：
文献类型：
--
作者：
Zada G
库欣氏病是由垂体腺瘤ACTH分泌过多引起的，并导致随后全身皮质醇升高，最终导致患者生存率降低。库欣氏病的诊断通常涉及一种逐步的方法，包括临床、实验室、神经影像学，有时还包括介入放射学技术，通常需要众多专业从业人员的多学科合作。垂体微腺瘤，不出现在指定的垂体MRI或动态对比协议可能构成一个特别具有挑战性的子集，这种疾病。库欣氏病的治疗通常包括经蝶窦手术切除垂体腺瘤作为一线选择，但可能需要增加预防性措施，如立体定向放射外科或药物管理，以实现血清皮质醇水平的正常化。为了检测可能发生的任何复发，甚至在最初缓解后数年，必须对患者进行警惕的长期连续内分泌监测。在本文中，逐步的诊断方法，和各种管理策略和相关的结果与库欣病患者进行了讨论。
Cushing's Disease is caused by oversecretion of ACTH from a pituitary adenoma and results in subsequent elevations of systemic cortisol, ultimately contributing to reduced patient survival. The diagnosis of Cushing's Disease frequently involves a stepwise approach including clinical, laboratory, neuroimaging, and sometimes interventional radiology techniques, often mandating multidisciplinary collaboration from numerous specialty practitioners. Pituitary microadenomas that do not appear on designated pituitary MRI or dynamic contrast protocols may pose a particularly challenging subset of this disease. The treatment of Cushing's Disease typically involves transsphenoidal surgical resection of the pituitary adenoma as a first-line option, yet may require the addition of adjunctive measures such as stereotactic radiosurgery or medical management to achieve normalization of serum cortisol levels. Vigilant long-term serial endocrine monitoring of patients is imperative in order to detect any recurrence that may occur, even years following initial remission. In this paper, a stepwise approach to the diagnosis, and various management strategies and associated outcomes in patients with Cushing's Disease are discussed.
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