ArticleEndocrine2017
Factors predicting the duration of adrenal insufficiency in patients successfully treated for Cushing disease and nonmalignant primary adrenal Cushing syndrome.
Article in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2024Guideline
- Adrenal rather than central dysfunction limits hypothalamic-pituitary-adrenal axis recovery after chronic glucocorticoid treatment in male mice.Endocrinology · 2026Article
- Aligning treatment to physiology: when to use chronotherapy, block and replace, or titration to treat hypercortisolism.Journal of the Endocrine Society · 2026Article
- Article
- Predictor of Steroid Replacement Duration after Removal of Cortisol-producing Adenoma.Internal medicine (Tokyo, Japan) · 2025Observational
- High recovery rate of adrenal function after successful surgical treatment of Cushing's syndrome.Endocrine connections · 2025Article
- Postoperative adrenal cortical insufficiency following adrenal adenoma removal: a case report.AME case reports · 2025Article
- No requirement of perioperative glucocorticoid replacement in patients with endogenous Cushing's syndrome - a pilot study.Endocrine · 2024Article
- Predicting postoperative hypocortisolism in patients with non-aldosterone-producing adrenocortical adenoma: a retrospective single-centre study.Journal of endocrinological investigation · 2024Article
- Long-Term Usage of Oral Glucocorticoids Leading to Adrenal Insufficiency: A Comprehensive Review of the Literature.Cureus · 2023Review
- "Fast First and Then Slowly" Steroid-Tapering Regimen in Managing Corticoid-Sensitive Patients With Severe Immunotherapy Complications After Anti-PD-(L)1 Therapy for Cancer.Clinical Medicine Insights. Oncology · 2023Article
- Factors predicting prolonged glucocorticoid therapy in patients with adrenal insufficiency after laparoscopic adrenalectomy.Annals of medicine and surgery (2012) · 2022Article
- Approach to the Patient With Adrenal Incidentaloma.The Journal of clinical endocrinology and metabolism · 2021Review
- The effects of mindfulness-based stress reduction therapy combined with intensive education on the effectiveness of the care and the awareness rate in patients with arthritis and diabetes.American journal of translational research · 2021Article
- Recovery of hypothalamic-pituitary-adrenal axis in paediatric Cushing disease.Clinical endocrinology · 2021Article
- A New Insight into the Surgical Treatment of Primary Macronodular Adrenal Hyperplasia.Journal of the Endocrine Society · 2020Article
- The Impact of Mild Autonomous Cortisol Secretion on Bone Turnover Markers.The Journal of clinical endocrinology and metabolism · 2020Article
- Observational
- Predictability of hypoadrenalism occurrence and duration after adrenalectomy for ACTH-independent hypercortisolism.Journal of endocrinological investigation · 2018Article
- Current best practice in the management of patients after pituitary surgery.Therapeutic advances in endocrinology and metabolism · 2017Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Successful treatment of Cushing syndrome causes transient or permanent adrenal insufficiency deriving from endogenous hypercortisolism-induced hypothalamus-pituitary-adrenal-axis suppression. We analyzed pre-treatment factors potentially affecting the duration of adrenal insufficiency. We conducted a retrospective analysis on patients successfully treated for Cushing disease (15 patients) who underwent transsphenoidal surgery, and nonmalignant primary adrenal Cushing syndrome (31 patients) who underwent unilateral adrenalectomy, divided into patients with overt primary adrenal Cushing syndrome (14 patients) and subclinical primary adrenal Cushing syndrome (17 patients). Epidemiological data, medical history, and hormonal parameters depending on the etiology of hypercortisolism were collected and compared to the duration of adrenal insufficiency. The median duration of follow-up after surgery for Cushing disease and primary adrenal Cushing syndrome was 70 and 48 months, respectively. In the Cushing disease group, the median duration of adrenal insufficiency after transsphenoidal surgery was 15 months: younger age at diagnosis and longer duration of signs and symptoms of hypercortisolism before diagnosis and surgery were associated with longer duration of adrenal insufficiency. The median duration of adrenal insufficiency was 6 months for subclinical primary adrenal Cushing syndrome and 18.5 months for overt primary adrenal Cushing syndrome. The biochemical severity of hypercortisolism, the grade of hypothalamus-pituitary-adrenal-axis suppression, and treatment with ketoconazole before surgery accounted for longer duration of adrenal insufficiency. In patients with Cushing disease, younger age and delayed diagnosis and treatment predict longer need for glucocorticoid replacement therapy after successful transsphenoidal surgery. In patients with primary adrenal Cushing syndrome, the severity of hypercortisolism plays a primary role in influencing the duration of adrenal insufficiency after unilateral adrenalectomy.
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