-
Views
-
Cite
Cite
Thomas Moshang, Cushing’s Disease, 70 Years Later … and the Beat Goes on, The Journal of Clinical Endocrinology & Metabolism, Volume 88, Issue 1, 1 January 2003, Pages 31–33, https://doi.org/10.1210/jc.2002-021753
Close - Share Icon Share
Extract
It was 70 yr ago, before most of the present endocrinologists were even born, when Harvey Cushing first described the finding of basophilic pituitary adenoma as a cause of the disorder that now bears his name (1). If one does a literature search, using the search words “Cushing’s syndrome,”over 8000 citations are listed, and close to 300 in the year 2002. So, after 70 yr, we are still publishing studies about Cushing’s disease because, clearly, our diagnostic, treatment, and posttreatment modalities can and need to be refined. This is especially true in the pediatric age range because the incidence of pituitary Cushing’s disease in children is rare as compared with the occurrence rate in adults. It is necessary after learning from studies related to adult patients to evaluate the extrapolated information to similarly affected children. Estrada et al. (2) reported several years ago the successful outcome using pituitary irradiation to treat adult patients with persistent or recurrent Cushing’s disease after transsphenoidal surgery. The success in inducing remission of Cushing’s disease after pituitary irradiation was time dependent, but perhaps the use of ketoconazole to treat the patients until biochemical and clinical cure was, as well, an important factor in terms of management. The time to remission was at least 6 months but was as long as 60 months. Subsequently, following pituitary irradiation of these adult patients, approximately 57% developed GH deficiency, 40% developed gonadotropin deficiency, 16% had TSH deficiency, and one patient demonstrated ACTH deficiency.
