Open AccessPrognostic value of the level of cortisol and ACTH in the blood of patients with Itsenko-Cushing's disease during surgical treatment with corticotropin
Author(s) -
Svetlana Arapova,
Yu. K. Trunin,
Е И Марова,
Н. П. Гончаров,
Г С Колесникова,
G. D. Nersesyan,
Б А Кадашев,
S. Yu. Kasumova
Publication year - 1998
Publication title -
problemy èndokrinologii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.124
H-Index - 5
eISSN - 2308-1430
pISSN - 0375-9660
DOI - 10.14341/probl11665
Subject(s) - medicine , cushing disease , cushing's disease , pituitary adenoma , hydrocortisone , adenoma , hormone , adrenalectomy , cushing syndrome , disease , gastroenterology , surgery , endocrinology , urology
Adenomectomy was carried out in 41 patients with Icenko-Cushing’s disease. Before surgery, computer-aided tomography showed pituitary adenomas in all the patients. The patients were divided into 2 groups. Group 1 consisted of 31 patients in whom the disease was diagnosed for the first time and group 2 of 10 patients previously treated by other methods (proton ther- ару and unilateral adrenalectomy) without effect. Pituitary adenomas were removed in all patients. Histological study showed hormone-active pituitary adenomas in all cases. The levels of hydrocortisone and ACTH in the plasma and daily urine were increased in both groups before the operation. Ten-twenty days after surgery, the levels of hydrocortisone and ACTH in group 1 were significantly lower than in group 2. We consider that the lower are the levels of these hormones early after surgery, the lower is the probability of a relapse. Postoperative hypocorticalism (10-20 days postoperation) is a good prognostic sign indicating radical removal of pituitary adenoma. Adenomectomy is indicated for patients with Icenko-Cushing’s disease as primary method of treatment.