Pathogenesis of Primary Adrenal Cushing’s Syndrome
Adrenocortical adenoma Micronodular disease Macronodular disease MAS PPNAD/iMAD/CNC BMAH A. Genetic alterations 1. cAMP/PKA signaling pathway – – MC2R a (missense) – GNAS a – GNAS a GNAS a…
Adrenocortical adenoma Micronodular disease Macronodular disease MAS PPNAD/iMAD/CNC BMAH A. Genetic alterations 1. cAMP/PKA signaling pathway – – MC2R a (missense) – GNAS a – GNAS a GNAS a…
Fig. 1 Pre-receptor regulation of glucocorticoid availability governs access to bind and activate the glucocorticoid receptor Circulating GC levels are tightly controlled by the hypothalamo–pituitary–adrenal (HPA) axis , which regulates…
Neoplastic/pathological hypercortisolism ACTH-secreting neoplasm Pituitary (Cushing disease) Non-pituitary (ectopic ACTH) Adrenal neoplastic disease Adrenocortical adenoma Adrenocortical carcinoma Bilateral adrenal nodular disease Primary pigmented micronodular hyperplasia Primary bilateral macronodular hyperplasia Nonneoplastic/physiological…
Author No. of patients (n) Follow-up (months) Remission rate (%) Overnight dexa Bochicchio et al. [41] 668 Mean 24; median 13 76.3 Chee et al. [56] 61 Median 88…
Fig. 1 Left adrenal incidentaloma with subtle autonomous cortisol secretion in a 37-year-old woman (white arrow); the right adrenal gland is partially atrophied (black arrow). Over 1 year, the cortisol…
Steroidogenesis inhibitors Ketoconazole Metyrapone Mitotane Etomidate Centrally acting agents Cabergoline Pasireotide Glucocorticoid receptor antagonist Mifepristone Note: With the exception of pasireotide and mifepristone, these agents are used “off-label” in Cushing’s…
Reference Type of MRI sequence Magnet strength (T) Matrix size TR/TE (ms) FOV (cm) Slice thickness (mm) Sensb FPc Kasaliwal et al. [9] Dynamic contrast spin echo (DC-SE) 1.5 256…
© Springer International Publishing Switzerland 2017Eliza B. Geer (ed.)The Hypothalamic-Pituitary-Adrenal Axis in Health and Disease10.1007/978-3-319-45950-9_3 Glucocorticoids: Inflammation and Immunity Maria G. Petrillo1, Carl D. Bortner1 and John A. Cidlowski1 (1) Signal Transduction Laboratory, National Institute of Environmental Health Sciences,…
Fig. 1 Effects of GCs on body composition and metabolism . GCs promote whole-body insulin resistance via visceral adipogenesis, mobilization, and release of free fatty acids into the circulation and…
Disease state Cognitive function Psychopathology Coping Strategies and illness perceptions Cushing’s syndrome or Cushing’s disease Active or uncontrolled disease Impaired Major depression, anxiety disorders, acute psychosis, delirium Not studied…