ArticleClinical endocrinology2018
Extensive clinical experience: Hypothalamic-pituitary-adrenal axis recovery after adrenalectomy for corticotropin-independent cortisol excess.
Article in Clinical endocrinology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 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
- Trial
- Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement.The Journal of clinical endocrinology and metabolism · 2026Review
- Potential mechanisms of the glucocorticoid withdrawal syndrome.European journal of endocrinology · 2026Review
- Article
- Cortisol Testing to Diagnose Adrenal Insufficiency Following Adrenalectomy for Mild Autonomous Cortisol Secretion.The Journal of clinical endocrinology and metabolism · 2026Article
- CAI Score for the Diagnosis of Central Adrenal Insufficiency.Journal of the Endocrine Society · 2026Article
- Addressing the Clinical Conundrum of Localization in ACTH-independent Cushing Syndrome With Bilateral Adrenal Nodules.JCEM case reports · 2025Article
- An Analysis of Post-Adrenalectomy Dynamics in MACS (Mild Autonomous Cortisol Secretion)-Positive Adrenal Tumours: The Biomarkers and Clinical Impact.Journal of clinical medicine · 2025Review
- 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
- Impact of hydrocortisone vs prednisone therapy on postsurgical recovery in patients with endogenous hypercortisolism: a prospective cohort study.European journal of endocrinology · 2025Article
- Glucocorticoid treatment and adrenal suppression in children: current view and open issues.Journal of endocrinological investigation · 2025Review
- Morning serum cortisol as a predictor of synacthen stimulation test outcomes during corticosteroid withdrawal: a comparative analysis of high-dose and low-dose protocols.Frontiers in endocrinology · 2025Article
- Targeting glucocorticoid receptor signaling pathway for treatment of stress-related brain disorders.Pharmacological reports : PR · 2024Review
- Cosyntropin Stimulation Testing is More Selective than Postoperative Day 1 Basal Cortisol for Diagnosing Secondary Adrenal Insufficiency After Unilateral Adrenalectomy.Annals of surgical oncology · 2024Article
- 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
- Challenges in the postsurgical recovery of cushing syndrome: glucocorticoid withdrawal syndrome.Frontiers in endocrinology · 2024Review
- Etiology, morphology, and outcomes of adrenal calcifications in 540 adult patients-a retrospective single-center study.European journal of endocrinology · 2023Article
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5 authors at 1 institution in 1 country.
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Abstract
objectiveTo identify predictors of hypothalamic-pituitary-adrenal (HPA) axis recovery interval and severity of glucocorticoid withdrawal symptoms (GWS) in patients undergoing adrenalectomy for corticotropin-independent cortisol excess.
designThis is a retrospective study of patients with mild autonomous cortisol excess (MACE), moderate and severe Cushing syndrome (CS) who developed adrenal insufficiency after unilateral adrenalectomy between 1998 and 2017.
resultsAdrenalectomy was performed in 81 patients (79% women, median age 52 years [IQR 42-62]). HPA axis recovery occurred at a median of 4.3 months (IQR 1.6-11.4) after adrenalectomy (severe CS vs moderate CS vs MACE: median 11.4 vs 2.8 vs 2.1 months, P < 0.01). Main predictors of HPA axis recovery interval included: preoperative serum cortisol concentration after 1-mg overnight dexamethasone suppression test >10 μg/dL or >276 nmol/L (9.7 vs 1.3 months if cortisol ≤10 μg/dL or ≤276 nmol/L, P < 0.01); body mass index (for every 3 kg/m
conclusionsThe HPA axis recovery interval was the longest for patients with severe CS. Surprisingly, patients with moderate CS recovered their HPA axis as quickly as those with MACE. Glucocorticoid withdrawal symptoms were observed in all groups, with more events in patients with severe CS. This study emphasizes the need to counsel patients on expectations for HPA axis recovery and address intervention for GWS based on individual preoperative parameters.
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