5 CASES OF CYCLICAL CUSHINGS-SYNDROME
5 CASES OF CYCLICAL CUSHINGS-SYNDROME
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DOI：
10.1136/bmj.291.6507.1453
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发表时间：
1985-01-01
影响因子：
105.7
通讯作者：
SHERIDAN, B
中科院分区：
文献类型：
--
作者：
ATKINSON, AB;KENNEDY, AL;SHERIDAN, B
周期性库欣综合征的病例报道是罕见的。在14例连续的库欣综合征患者中，9例收集了连续的尿液样本来估计皮质醇：肌酐比值。5例患者有周期性库欣综合征，2例患者尿皮质醇分泌有明显变化，但未建立周期性模式。5例周期性综合征患者中有2例对地塞米松有矛盾的反应。只有一名周期性患者在接受溴隐亭或赛庚啶治疗后，皮质醇：肌酐比值下降。周期性库欣综合征的高发病率具有重要的临床意义。有库欣综合征症状或体征但皮质醇值正常的患者、皮质醇值波动的患者和对地塞米松有异常反应的患者需要高度怀疑该综合征。由于甾体生成可能存在差异，因此对库欣综合征的药物研究结果必须谨慎解释。
Reported cases of cyclical Cushing''s syndrome are rare. Of 14 successive patients with Cushing''s syndrome nine collected sequential urine samples for the estimation of cortisol:creatinine ratio. Five had cyclical Cushing''s syndrome while two had considerable variation in urinary cortisol excretion without a cyclical pattern being established. Two of the five patients with a cyclical syndrome had paradoxical responses to dexamethasone. In only one patient with a cyclical pattern did the cortisol: creatinine ratio fall after treatment with bromocriptine or cyproheptadine, or both. The high incidence of the cyclical form of Cushing''s syndrome has important clinical implications. A high index of suspicions of the syndrome is required in patients with symptoms or signs of Cushing''s syndrome but with normal cortisol values, in patients with fluctuating cortisol values, and in patients with anomalous responses to dexamethasone. Because of possible variations in steroidogenesis the results of drug studies in Cushing''s syndrome must be interpreted cautiously.