Prognosis of patients treated for Cushing syndrome

Endocrinol Nutr. 2014 Jan;61(1):52-61. doi: 10.1016/j.endonu.2013.03.008. Epub 2013 Jul 3.
[Article in English, Spanish]

Abstract

Cushing syndrome (CS), due to an ACTH-secreting pituitary adenoma, adrenal tumors, or ectopic ACTH secretion, causes hypercortisolism. CS is associated with major morbidity, especially metabolic and cardiovascular complications, osteoporosis, psychiatric changes, and cognitive impairment. Despite biochemical "cure" of hypercortisolism and clinical improvement after effective treatment, these complications are only partially reversible. Exacerbation of prior autoimmune diseases is also seen. All of these lead to quality of life impairment and increased mortality. This review addresses the main comorbidities and long-term consequences of CS despite clinical and biochemical "cure".

Keywords: Calidad de vida relacionada con la salud; Cardiovascular risk; Cushing disease; Cushing syndrome; Enfermedad de Cushing; Health-related quality of life; Mortalidad; Mortality; Osteoporosis; Remisión; Remission; Riesgo cardiovascular; Síndrome de Cushing.

Publication types

  • Review

MeSH terms

  • ACTH-Secreting Pituitary Adenoma / complications
  • ACTH-Secreting Pituitary Adenoma / surgery
  • Adrenal Cortex Neoplasms / complications
  • Adrenal Cortex Neoplasms / surgery
  • Adrenalectomy
  • Adrenocortical Adenoma / complications
  • Adrenocortical Adenoma / surgery
  • Adrenocorticotropic Hormone / metabolism
  • Cushing Syndrome / etiology
  • Cushing Syndrome / physiopathology
  • Cushing Syndrome / therapy*
  • Humans
  • Hydrocortisone / metabolism
  • Hypophysectomy*
  • Pituitary ACTH Hypersecretion / complications
  • Pituitary ACTH Hypersecretion / surgery
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / surgery
  • Pituitary-Adrenal System / physiopathology
  • Prognosis
  • Quality of Life

Substances

  • Adrenocorticotropic Hormone
  • Hydrocortisone