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Journal of Clinical Endocrinology & Metabolism, Vol 43, 913-918, Copyright © 1976 by Endocrine Society

ARTICLES

Periodic remission in Cushing's disease with paradoxical dexamethasone response: an expression of periodic hormonogenesis

B Liberman, BL Wajchenberg, MA Tambascia and CH Mesquita

A patient with Cushing's disease due to a chromophobe adenoma was studied for 243 days before pituitary surgery and evidence for periodicity in cortisol steroid production was found with cycles occurring every 85.8 days (peak-to-peak length), associated with laboratory remissions and paradoxical response to dexamethasone. The autonomy of ACTH secretion was suggested by the nonresponsiveness to repeated lysine-vasopressin stimulation tests and lack of increase in urinary 170HCS following metyrapone. A distinct response of the hyperplastic glands (as demonstrated by percutaneous adrenal venography) was obtained on several B1-24 corticotropin stimulation. The patient's hypercortisolism disappeared following removal of the chromophobe adenoma through transphenoidal hypophysectomy.


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J R Meinardi, B H R Wolffenbuttel, and R P F Dullaart
Cyclic Cushing's syndrome: a clinical challenge
Eur. J. Endocrinol., September 1, 2007; 157(3): 245 - 254.
[Abstract] [Full Text] [PDF]


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