Clinical features and progress in diagnosis and treatment of mild autonomous cortisol secretion
10.3760/cma.j.cn112330-20240327-00154
- VernacularTitle:轻微自主皮质醇分泌的临床特点及诊疗进展
- Author:
Shiming WANG
1
;
Weiwei FAN
;
Jiacheng JIN
;
Xinqing HAO
;
Jianbo WANG
Author Information
1. 大连医科大学附属第一医院泌尿外科，大连 116011
- Keywords:
Subclinical Cushing's syndrome;
Mild autonomous cortisol secretion;
Increased cortisol;
Adrenal glands;
Adrenal incidentaloma
- From:
Chinese Journal of Urology
2024;45(4):325-328
- CountryChina
- Language:Chinese
-
Abstract:
Mild autonomous cortisol secretion (MACS) is a condition indicated by biochemical testing for autonomous cortisol secretion, yet it lacks the classical signs of Cushing's Syndrome, such as moon face, buffalo hump, plethoric appearance, and purple striae. It is predominantly observed in middle-aged women and is commonly associated with adrenal incidentalomas. Due to the lack of significant clinical signs, the diagnosis of MACS primarily relies on hormonal testing. Patients with MACS often present with comorbidities such as hypertension, diabetes, and osteoporosis. For those with comorbid conditions, surgical treatment is the principal therapeutic approach. This article summarizes recent national and international guidelines and research to elucidate the updates to the diagnostic criteria for MACS, with a particular focus on the interpretation of the 1 mg overnight dexamethasone suppression test results. It also details the treatment and follow-up strategies for MACS. Furthermore, the article highlights the urgent need for more extensive prospective studies to refine the existing diagnostic criteria and to develop surgical guidelines for a wider range of patients with MACS.
