Subclinical Cushing’s syndrome: lots of questions — little answers

The literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex ade...

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Main Author: S.І. Rybakov
Format: Article
Language:English
Published: Zaslavsky O.Yu. 2021-10-01
Series:Mìžnarodnij Endokrinologìčnij Žurnal
Subjects:
Online Access:http://iej.zaslavsky.com.ua/article/view/243216
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author S.І. Rybakov
author_facet S.І. Rybakov
author_sort S.І. Rybakov
collection DOAJ
description The literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex adenoma, suppression of the adrenocorticotropic function of the pituitary gland and the functional state of the opposite adrenal gland. Such a condition may be clinically asymptomatic or be accompanied by some nonspecific signs of hypercortisolism (arterial hypertension, diabetes mellitus, obesity, osteoporosis). Noteworthy is the large variability in the frequency of its detection, which is possibly due to the use of various criteria for assigning individual cases to this category. As a basic screening test for the detection of subclinical hypercortisolism, most researchers consider the most acceptable and effective night suppressive test with 1.0 mg of dexamethasone. Modern tactical and technical approaches to the treatment of subclinical Cushing’s syndrome are quite diverse and are more often based on pragmatic principles than on reliably substantiated ones. The author raises the question: could subclinical Cushing’s syndrome be the result of hyperfunction of normal or diffusely enlarged (hyperplastic) adrenal glands as a result of some disturbances in the hypothalamic-pituitary-adrenal hierarchy. And, finally, are the disorders “accompanying” subclinical Cushing’s syndrome a consequence of the overproduction of cortisol, although often insignificant, or can they be the cause of the onset of subclinical hypercortisolism? For the treatment of subclinical hypercortisolism, adrenalectomy is currently proposed, with the aim of reducing the intake of excessive amounts of glucocorticoids into the patient’s body, leading to the development of these disorders. Known drug methods of suppressing the function of the adrenal cortex — drugs chloditan, mitotane, ketoconazole.
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spelling doaj.art-c49a24aeb0b94824a9ca4a6b524a97842022-12-22T01:40:09ZengZaslavsky O.Yu.Mìžnarodnij Endokrinologìčnij Žurnal2224-07212307-14272021-10-0117650351210.22141/2224-0721.17.6.2021.243216281017Subclinical Cushing’s syndrome: lots of questions — little answersS.І. RybakovThe literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex adenoma, suppression of the adrenocorticotropic function of the pituitary gland and the functional state of the opposite adrenal gland. Such a condition may be clinically asymptomatic or be accompanied by some nonspecific signs of hypercortisolism (arterial hypertension, diabetes mellitus, obesity, osteoporosis). Noteworthy is the large variability in the frequency of its detection, which is possibly due to the use of various criteria for assigning individual cases to this category. As a basic screening test for the detection of subclinical hypercortisolism, most researchers consider the most acceptable and effective night suppressive test with 1.0 mg of dexamethasone. Modern tactical and technical approaches to the treatment of subclinical Cushing’s syndrome are quite diverse and are more often based on pragmatic principles than on reliably substantiated ones. The author raises the question: could subclinical Cushing’s syndrome be the result of hyperfunction of normal or diffusely enlarged (hyperplastic) adrenal glands as a result of some disturbances in the hypothalamic-pituitary-adrenal hierarchy. And, finally, are the disorders “accompanying” subclinical Cushing’s syndrome a consequence of the overproduction of cortisol, although often insignificant, or can they be the cause of the onset of subclinical hypercortisolism? For the treatment of subclinical hypercortisolism, adrenalectomy is currently proposed, with the aim of reducing the intake of excessive amounts of glucocorticoids into the patient’s body, leading to the development of these disorders. Known drug methods of suppressing the function of the adrenal cortex — drugs chloditan, mitotane, ketoconazole.http://iej.zaslavsky.com.ua/article/view/243216subclinical cushing’s syndrome, frequency, diagnosis, treatment, review
spellingShingle S.І. Rybakov
Subclinical Cushing’s syndrome: lots of questions — little answers
Mìžnarodnij Endokrinologìčnij Žurnal
subclinical cushing’s syndrome, frequency, diagnosis, treatment, review
title Subclinical Cushing’s syndrome: lots of questions — little answers
title_full Subclinical Cushing’s syndrome: lots of questions — little answers
title_fullStr Subclinical Cushing’s syndrome: lots of questions — little answers
title_full_unstemmed Subclinical Cushing’s syndrome: lots of questions — little answers
title_short Subclinical Cushing’s syndrome: lots of questions — little answers
title_sort subclinical cushing s syndrome lots of questions little answers
topic subclinical cushing’s syndrome, frequency, diagnosis, treatment, review
url http://iej.zaslavsky.com.ua/article/view/243216
work_keys_str_mv AT sírybakov subclinicalcushingssyndromelotsofquestionslittleanswers