Cushing′s disease: a comparison between pituitary macroadenoma and microadenoma
- VernacularTitle:库欣病:垂体大腺瘤与微腺瘤的比较
- Author:
Aiping WANG
;
Yingzhang WANG
;
Hongbo GAI
- Publication Type:Journal Article
- Keywords:
Cushing′s disease;
Macroadenoma;
Microadenoma
- From:
Chinese Journal of Endocrinology and Metabolism
1986;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the difference of clinical characteristics between patients with pituitary corticotroph macroadenoma and microadenoma. Methods From 1985 to 1998, 76 inpatients with Cushing′s disease, 12 cases of macroadenoma and 64 cases of microadenoma were reviewed. The clinical manifestations, the course before diagnosis, blood routine, biochemical and endocrinic examinations were retrospectively analyzed. Results Defect of vision field and galactorrhea were more frequent and the duration of disease before diagnosis were shorter in macroadenomas than those in microadenomas. Lymphopenia, hypokalaemia, lower creatine kinase level and hyperphosphoroemia were also more pronounced in macroadenomas. In macroadenomas, the plasma ACTH and cortisol (F) concentrations at 0:00 were obviously higher than those in microadenomas, but plasma ACTH and F at 8:00 and 24h urinary free cortisol were similar in these two groups. The relative nyctohemeral variation of ACTH was less in macroadenomas than that in microadenomas, the relative nyctohemeral variation of F was similar in these two groups. One month after operation, clinicl manifestations of macroadenomas significantly improved, but the number of these patients with significant blood ACTH decrease was significantly less than that in microadenomas. Conclusion Due to higher amount and automatism of ACTH secretion, increased blood F level induces variation of clinical characteristics and laboratorial findings in patients with macroadenoma compared to the patients with microadenoma.
