Cushing's Syndrome Treatment
Key Points
Key Points
Effective treatment includes the normalization of cortisol levels or action. It also includes the normalization of comorbidities via directly treating the cause of CS and by adjunctive treatments (e.g., antihypertensives).
Surgical resection of the causal lesion(s) is generally the first-line approach.
The choice of second-line treatments, including medication, bilateral adrenalectomy, and RT (for corticotroph tumors), must be individualized to each patient.
Treatment
...reatmen...
Treatment Goals for Cushing’s S...
...th overt CS, the Endocrine Society (ES) rec...
...S recommends against treatment to...
...ggests against treatments designed to n...
...timal Adjunctive Mana...
...ends providing education to patien...
...hat all patients receive monitoring and a...
...ommends that a multidisciplinary team, inc...
...gests evaluating CS patients for risk factor...
...patients with CS undergoing surgery, ES suggests...
...that clinicians discuss and offer...
...Treatment Options...
...initial resection of primary lesion(s) un...
...ilateral resection by an experience...
...nds localizing and resecting ectopic ACTH-...
...ranssphenoidal selective adenomectomy (TSS) b...
...ds measuring serum sodium several times during...
...ends assessing free thyroxine and prolactin wi...
ES recommends obtaining a postoperat...
...ends surgical resection of bilateral adrenal disor...
...ission and Recurrence After Surgical Tumor R...
...individualized management approach based on whet...
...dditional treatments in patients w...
ESS recommends measuring late-night...
...ends using tests to screen for hyperc...
...cocorticoid Replacement and Discontinuation, an...
...commends that hypocortisolemic patient...
...ends follow-up morning cortisol and/or ACTH...
...mends re-evaluating the need for treatment...
...ine Therapeutic Options...
...patients with ACTH-dependent CS w...
...s bilateral adrenalectomy for occult or...
...s regularly evaluating for corticotro...
...t Transsphenoidal Su...
...suggests repeat transsphenoidal surgery, particu...
...py/Radiosurgery for Cushing's Disease...
...confirming that medical therapy is effective i...
...T/radiosurgery in patients who have...
...s using RT where there are concerns ab...
...commends measuring serum cortisol or UFC o...
...edical Rx...
...ecommends steroidogenesis inhibitors under the f...
...uggests pituitary-directed medical treatments...
...ests administering a glucocorticoid antag...
...rgeted therapies to treat ectopic ACTH syndrome....
...ulations/Considerations...
...ends urgent treatment (within 24-72 ho...
...disorder(s) should be addressed as well...
...proach for Long-term F...
...ommends treating the specific comorbidities...
...commends educating patients and families abo...
...tients with adrenal adenoma, ES suggests foll...
...tients with adrenal adenoma, ES suggests follow-...
...nds that patients with Carney complex...
...Suggested Algorithm for the Treatment of Cush...
...1. Medical Treatment of Cushing’s...