Follow-up Study on Treatment in 27 Patients with Cushings Disease: Adrenalectomy, Transsphenoidal Adenomectomy and Medical Treatment
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概要
- 論文の詳細を見る
27 patients with Cushings disease were treated over a period of 18 years at the Departments of Medicine and Surgery, Nagoya University School of Medicine and the following results were obtained. 1) Adrenalectomy. 21 of 27 patients with Cushings disease underwent adrenalectomy. 19 patients had total bilateral adrenalectomy and 2 patients unilateral adrenalectomy. 4 patients died, the cause of death not being related directly to adrenalectomy. 9 of 15 bilaterally adrenalectomized patients had hyperpigmentation even though they had been given substitution therapy with cortisol 20-30mg daily. They had elevated plasma ACTH levels, which were not completely suppressed by 2 mg of dexamethasone or 2.5 mg of bromocriptine per day. 2) Adenomectomy. 5 patients had adenomectomy via the transsphenoidal approach. 3 patients were cured but one of them has required postoperative substitution therapy with cortisol for hypopituitarism for one year until today. 2 of 5 adenomectomized patients had a recurrence of Cushings syndrome after remission for 6-8 months. One of these recurrent cases has been subsequently treated successfully with bromocriptine, a dopaminergic drug. 3) Medical treatment. 2.5mg per day of bromocriptine has been effective in 2 patients without a pituitary adenoma and ineffective in the other 4 patients with a pituitary adenoma. 24 mg per day of cyproheptadine, an antiserotoninergic drug was not effective in any of the 4 patients with a pituitary adenoma.
- 社団法人 日本内分泌学会の論文
著者
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Kuwayama Akio
Department Of Neurosurgery Matsunami General Hospital
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Kageyama Naoki
Department Of Neurosurgery Kishiwada City Hospital
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TOMITA AKIO
1st Department of Internal Medicine, 2nd Department of Surgery
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SUZUKI SUSUMU
1st Department of Internal Medicine, 2nd Department of Surgery
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HARA IWAO
1st Department of Internal Medicine, 2nd Department of Surgery
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OISO YUTAKA
1st Department of Internal Medicine, 2nd Department of Surgery
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MIZUNO SHIGERU
1st Department of Internal Medicine, 2nd Department of Surgery
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YOGO HIROSHI
1st Department of Internal Medicine, 2nd Department of Surgery
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