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Cushing's Syndrome - Springer Nature

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Last Updated: 16 January 2022

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Evaluation of procoagulant imbalance in Cushing’s syndrome after short- and long-term remission of disease

Objective Patients with Cushing's syndrome are at a high risk of venous thromboembolism owing to a procoagulant imbalance, which is primarily related to a hypercoagulation defect. A global representation of coagulation is provided by thrombin activity measured with and without the addition of thrombomodulin. Patients with active hypercortisolism have been characterized by the endogenous thrombin potential, and previous studies have shown a hypercoagulable profile in patients with active hypercortisolism. The aim of this investigation was to determine the short- and long-term improvement of ETP in patients with CS after disease remission. At various time points in history, five patients with CS for whom surgical remission were successful were prospectively inspected for clinical characteristics, cortisol secretion profile, and ETP at various time points: before surgical intervention; after 6 months and 5 years of constant remission. There was no evidence of a significant relationship between ETP-ratio and cortisol secretion. Conclusions: Plasma hypercoagulation in patients with active hypercortisolism persists at short-term review and seems to be essentially reversible after long-term disease remission.

Source link: https://doi.org/10.1007/s40618-021-01605-5


Ectopic Cushing’s syndrome due to thymic neuroendocrine tumours: a systematic review

Short series or single instances are the only instances that have asymptomatic Cushing's syndrome related to thymic neuroendocrine tumors. We want to conduct systematic investigation using PubMed, Embase, Scopus, Ovid Medline, and Biosis. All cases with ectopic CS owing to thymic NETs have been reported in the last 40 years, with a single illustrative patient attending in our institution are described in our study. The median of symptoms and diagnosis was 6 [2–24] months old, and 62% had a strong CS before diagnosis. Imaging was positive in 93. 7%, 97. 8%, 80%, and 79. 8%, with median tumor size of 47 [25–68. 5] mm. In 70%, 63% under radiotherapy and 45. 2% chemotherapy, Tumour persisted or recurred in 70 percent, 63% received radiotherapy, and 48 percent received chemotherapy. In 3. 8 percent, the MEN-1 mutation was defined in 3. 9%. Comparatively, carcinomas had aggressive CS more often than atypical, with advanced disease more often. In conclusion, thymic NETs that cause ectopic CS are described as a form of aggressive hypercortisolism in the middle aged population.

Source link: https://doi.org/10.1007/s11154-021-09660-2


Rare complication of cushing’s syndrome in the elderly: a case report

Purpose Cushing's syndrome is a rare and severe disease characterized by chronic hypercortisolism. To our knowledge, PF in a patient with CS has never been reported before. Methods We described an 84-year-old female with severe syphilis but normal temperature, but no fever was present. Endogenous CS was diagnosed, combined with clearly elevated serum cortisol and adenoma revealed by adrenal CT scanning. During hospitalization, the patient sustained significant subcutaneous hemorrhage on the right thigh and back. Purpura Fulminans - Multiple small vessel thrombosis were detected during a skin biopsy, indicating that the patient developed the uncommon condition of CS. When CS is a problem for infectious PF, fluid resuscitation, antibiotics, infusion of blood product, and debridement were all successful treatment options. Conclusion Severe subcutaneous hemorrhage due to PF may occur in CS patients, especially elderly patients. Clinicians should be aware of the diagnosis of CS in older adults with cognitive decline and personality changes.

Source link: https://doi.org/10.1007/s12020-021-02844-5

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions