A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/195777 |
Resumo: | The treatment objectives for a patient with Cushing’s disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure. Medical treatment, radiotherapy and adrenalectomy are the other options when transsphenoidal pituitary surgery fails.There are several options of medical treatment, although cabergoline and ketoconazole are the most commonly used alone or in combination. Novel treatments are also addressed in this review. Different therapeutic approaches are frequently needed on an individual basis, both before and, particularly, after surgery, and they should be individualized. The objective of the present review is to provide the necessary information to achieve a more effective treatment for CD. It is recommended that patients with CD be followed at tertiary care centers with experience in treating this condition. |
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Machado, Márcio CarlosFragoso, Maria Candida Barisson VillaresMoreira, Ayrton CustódioBoguszewski, Cesar LuizVieira Neto, LeonardoNaves, Luciana AnsaneliVilar, LucioAraújo, Luiz Antônio deMusolino, Nina R. de C.Miranda, Paulo AugustoCzepielewski, Mauro AntonioGadelha, Mônica RobertoBronstein, Marcello D.Oliveira Junior, Antonio Ribeiro de2019-06-14T02:30:51Z20182359-4292http://hdl.handle.net/10183/195777001095516The treatment objectives for a patient with Cushing’s disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure. Medical treatment, radiotherapy and adrenalectomy are the other options when transsphenoidal pituitary surgery fails.There are several options of medical treatment, although cabergoline and ketoconazole are the most commonly used alone or in combination. Novel treatments are also addressed in this review. Different therapeutic approaches are frequently needed on an individual basis, both before and, particularly, after surgery, and they should be individualized. The objective of the present review is to provide the necessary information to achieve a more effective treatment for CD. It is recommended that patients with CD be followed at tertiary care centers with experience in treating this condition.application/pdfengArchives of endocrinology and metabolism. São Paulo. Vol. 62, no. 1 (2018), p. 87-105.Síndrome de CushingRevisãoTerapêuticaBrasilSociedade Brasileira de Endocrinologia e MetabologiaCushing’s diseaseCushing’s syndromeTreatmentBrazilA review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolisminfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001095516.pdf.txt001095516.pdf.txtExtracted Texttext/plain100245http://www.lume.ufrgs.br/bitstream/10183/195777/2/001095516.pdf.txt91f859b35f378af0b917841c42411c82MD52ORIGINAL001095516.pdfTexto completo (inglês)application/pdf362857http://www.lume.ufrgs.br/bitstream/10183/195777/1/001095516.pdf00827eec5b908f74f6e4c69526d1312aMD5110183/1957772022-08-11 04:40:44.052138oai:www.lume.ufrgs.br:10183/195777Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2022-08-11T07:40:44Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
title |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
spellingShingle |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism Machado, Márcio Carlos Síndrome de Cushing Revisão Terapêutica Brasil Sociedade Brasileira de Endocrinologia e Metabologia Cushing’s disease Cushing’s syndrome Treatment Brazil |
title_short |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
title_full |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
title_fullStr |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
title_full_unstemmed |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
title_sort |
A review of Cushing’s disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism |
author |
Machado, Márcio Carlos |
author_facet |
Machado, Márcio Carlos Fragoso, Maria Candida Barisson Villares Moreira, Ayrton Custódio Boguszewski, Cesar Luiz Vieira Neto, Leonardo Naves, Luciana Ansaneli Vilar, Lucio Araújo, Luiz Antônio de Musolino, Nina R. de C. Miranda, Paulo Augusto Czepielewski, Mauro Antonio Gadelha, Mônica Roberto Bronstein, Marcello D. Oliveira Junior, Antonio Ribeiro de |
author_role |
author |
author2 |
Fragoso, Maria Candida Barisson Villares Moreira, Ayrton Custódio Boguszewski, Cesar Luiz Vieira Neto, Leonardo Naves, Luciana Ansaneli Vilar, Lucio Araújo, Luiz Antônio de Musolino, Nina R. de C. Miranda, Paulo Augusto Czepielewski, Mauro Antonio Gadelha, Mônica Roberto Bronstein, Marcello D. Oliveira Junior, Antonio Ribeiro de |
author2_role |
author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Machado, Márcio Carlos Fragoso, Maria Candida Barisson Villares Moreira, Ayrton Custódio Boguszewski, Cesar Luiz Vieira Neto, Leonardo Naves, Luciana Ansaneli Vilar, Lucio Araújo, Luiz Antônio de Musolino, Nina R. de C. Miranda, Paulo Augusto Czepielewski, Mauro Antonio Gadelha, Mônica Roberto Bronstein, Marcello D. Oliveira Junior, Antonio Ribeiro de |
dc.subject.por.fl_str_mv |
Síndrome de Cushing Revisão Terapêutica Brasil Sociedade Brasileira de Endocrinologia e Metabologia |
topic |
Síndrome de Cushing Revisão Terapêutica Brasil Sociedade Brasileira de Endocrinologia e Metabologia Cushing’s disease Cushing’s syndrome Treatment Brazil |
dc.subject.eng.fl_str_mv |
Cushing’s disease Cushing’s syndrome Treatment Brazil |
description |
The treatment objectives for a patient with Cushing’s disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure. Medical treatment, radiotherapy and adrenalectomy are the other options when transsphenoidal pituitary surgery fails.There are several options of medical treatment, although cabergoline and ketoconazole are the most commonly used alone or in combination. Novel treatments are also addressed in this review. Different therapeutic approaches are frequently needed on an individual basis, both before and, particularly, after surgery, and they should be individualized. The objective of the present review is to provide the necessary information to achieve a more effective treatment for CD. It is recommended that patients with CD be followed at tertiary care centers with experience in treating this condition. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018 |
dc.date.accessioned.fl_str_mv |
2019-06-14T02:30:51Z |
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info:eu-repo/semantics/article info:eu-repo/semantics/other |
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info:eu-repo/semantics/publishedVersion |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10183/195777 |
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2359-4292 |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Archives of endocrinology and metabolism. São Paulo. Vol. 62, no. 1 (2018), p. 87-105. |
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