Evidence map›Paper›PMID 36609908›Full record

Observational studyEndocrine2023

Clinical profile and treatment outcomes of patients with ectopic ACTH syndrome compared to Cushing disease: a single-center experience.

Bhawna Attri, Alpesh Goyal, Mani Kalaivani, Devasenathipathy Kandasamy, Yashdeep Gupta, Shipra Agarwal, Shamim A Shamim, Nishikant Damle, Atul Dhingra, Viveka P Jyotsna and 2 more

Abstract readObservational Study
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In one paragraph

Observational study in Endocrine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
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  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Bhawna AttriDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Alpesh GoyalDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India. alpeshgoyal89@gmail.com.ORCID 0000-0003-0922-5022
Mani KalaivaniDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Devasenathipathy KandasamyDepartment of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Yashdeep GuptaDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Shipra AgarwalDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Shamim A ShamimDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Nishikant DamleDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Atul DhingraDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Viveka P JyotsnaDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Ashish SuriDepartment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Nikhil TandonDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
All India Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to evaluate and compare the clinical, biochemical and radiological profile and outcomes of patients with ectopic ACTH syndrome (EAS) and Cushing disease (CD) treated over a period of 10 years (2013-2022).

methodsIn this ambispective observational study, we collected data for 146 patients with ACTH-dependent CS (EAS, n = 23; CD, n = 94; occult ACTH source, n = 29). Relevant details were filled in a predesigned proforma and outcomes were ascertained at the most recent visit.

resultsEAS was more common in males (65.2 vs. 27.6%, p < 0.001). Patients with EAS had a shorter duration of symptoms [12 (6-12) vs. 31.5 (15-48) months, p < 0.001] and were more likely to have hypokalemia (82.6 vs. 21.0%, p = 0.001), pedal edema (65.2 vs. 34.2%, p = 0.015), weight loss (34.8 vs. 4.0%, p < 0.001) and systemic infection (30.4 vs. 6.5%, p = 0.006). They also had significantly higher 8 a.m. serum cortisol, midnight serum and salivary cortisol and 8 a.m. plasma ACTH levels. Bronchial carcinoid (n = 10, 43.5%) was the most common etiology of EAS. Bilateral adrenalectomy was performed in 11 (47.8%) patients with EAS. Eight patients (34.8%) with EAS died at the last follow-up, of whom 7 (87.5%) had metastatic disease. In CD group, overall remission rate was 69.4% (56.1%, early and 13.3%, delayed) and 26.3% of patients with an initial remission had recurrence.

conclusionsBronchial carcinoid was the most common cause of EAS in our cohort. Bilateral adrenalectomy was performed in approximately every 1 in 2 patients with EAS and approximately every 1 in 3 patients expired till the last follow-up.

Indexed as

ACTH Syndrome, EctopicBronchial NeoplasmsCarcinoid TumorCushing SyndromePituitary ACTH HypersecretionAdrenocorticotropic HormoneHumansHydrocortisoneMaleTreatment OutcomeAdrenocorticotropic HormoneHydrocortisoneBilateral adrenalectomyBronchial carcinoidCushing diseaseCushing syndromeEctopic ACTH syndromeRemission

Identifiers

PMID36609908
OpenAlexW4313655666

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.