ArticleArchives of endocrinology and metabolism2019
Long-term outcome after bilateral adrenalectomy in Cushing's disease with focus on Nelson's syndrome.
Article in Archives of endocrinology and metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 3 syntheses or guidelines pooled it, 10 citations in OpenAlex.
- Metastatic pituitary tumors: an institutional case series.Pituitary · 2023Pooled it
- Prevalence of Nelson's syndrome after bilateral adrenalectomy in patients with cushing's disease: a systematic review and meta-analysis.Pituitary · 2021Pooled it
- Corticotroph tumor progression after bilateral adrenalectomy (Nelson's syndrome): systematic review and expert consensus recommendations.European journal of endocrinology · 2021Pooled it
- Role of Surgery in the Multimodal Treatment of Pituitary Carcinoma: A Retrospective Single-Institution Case Series.Cancers · 2026Article
- Clinical presentation, predictive factors and management of patients with Nelson syndrome: a retrospective study.Pituitary · 2025Article
- Management of Nelson's Syndrome.Medicina (Kaunas, Lithuania) · 2022Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe analyzed the clinical, biochemical, and imaging findings of adrenalectomized patients with Cushing's disease (CD) in order to compare the characteristics of those who developed Nelson's syndrome (NS) versus those who did not develop this complication (NNS), aiming to identify possible predictive factors for its occurrence. SUBJECTS AND
methodsWe performed a retrospective review of the clinical records of a group of patients with CD who underwent TBA between 1974 and 2011.
resultsOut of 179 patients with CD, 13 (7.3%) underwent TBA. NS occurred in 6 of them (46%) after a mean of 24 months from the total bilateral adrenalectomy (TBA). Age at diagnosis, duration of Cushing's syndrome (CS) until TBA, and steroid replacement doses were similar in both groups. Initial urinary cortisol levels (24-hour urinary free cortisol [UFC]) were significantly higher in the NS group than in the NNS group (p = 0.009). Four patients in the NS group and three of those in the NNS group received radiotherapy before TBA (p = 0.26). Three patients in the NS group presented residual tumors before TBA, compared with none in the NNS group (p = 0.04). At 1 year after TBA, the median ACTH level was 476 ng/L (240-1500 ng/L) in the NS group and 81 ng/L (48-330 ng/L) in the NNS group (p = 0.0007).
conclusionIn conclusion, a residual tumor before TBA, higher 24-hour UFC at diagnosis, and increasing ACTH levels within 1 year after TBA emerged as predictive factors of development of NS.
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