Approach to the patients with cyclic Cushing's syndrome

VernacularTitle:周期性库欣综合征的临诊应对
Author: Jia LI ^{1
,

2} ; 南开大学医学院 ; Li ZANG ; Tao ZHOU ; Jin DU ; Zhaohui LYU ; Yiming MU
Author Information

1. 100853北京,解放军总医院内分泌科
2. 南开大学医学院
Keywords: Cushing's syndrome; ACTH-secretion pituitary adenoma; Positron emission tomography
From: Chinese Journal of Endocrinology and Metabolism 2017;33(12):1063-1067
CountryChina
Language:Chinese
Abstract: Cyclic Cushing's syndrome is a special manifestation of Cushing's syndrome, of which the serum cortisol is only periodically increased. The causes include Cushing' s disease, ectopic adrenocorticotropic hormone ( ACTH)-producing syndrome, and primary adrenal disease. It is difficult to diagnose because the cycle length varies from hours to years and the clinical signs may show spontaneous remissions and recurrent attacks. The detection methods include either measurement of serum cortisol, 24 h urinary free cortisol, early-morning urinary cortisol/creatinine, salivary cortisol or hair cortisol. No matter which method to be used, repeated and continuous measurement is essential. Here, we present a female patient who was diagnosed as cyclic Cushing's syndrome due to a pituitary ACTH adenoma. The clinical features, detection methods, diagnosis, and treatment strategies of cyclic Cushing' s syndrome are also reviewed in this article.