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Cyclic Cushing’s Disease

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Cushing's Disease

Part of the book series: Endocrine Updates ((ENDO,volume 31))

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Abstract

Cyclic Cushing’s disease (CD) is characterized by fluctuations in clinical or biochemical indices of hypercortisolism, and is often marked by periods of ­disease activity alternating with relative quiescence. Retrospectively collected data suggest that cyclic CD accounts for approximately 15–19% of all CD cases. The pathogenesis of this condition remains obscure. Other than the presence of spontaneous fluctuations in its course, there are no distinguishing clinical or laboratory features of cyclic CD. However, the presence of varying degrees of hypercortisolism during its natural history frequently leads to major diagnostic difficulties, confounding the interpretation of diagnostic testing. Furthermore, assessment of the outcome of therapeutic interventions can be hampered by the intermittent nature of hypercortisolism inherent in cyclic CD. Prospective studies may be helpful in further elucidating the natural history of cyclic CD and molecular studies will be needed to understand the pathophysiology of this enigmatic and challenging condition.

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Authors and Affiliations

  1. Neuroendocrine Unit, Massachusetts General Hospital, Zero Emerson Place, Suite #112, Boston, MA, 02114, USA

    Nicholas A. Tritos

  2. Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Beverly M. K. Biller

Authors
  1. Nicholas A. Tritos
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  2. Beverly M. K. Biller
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Correspondence to Nicholas A. Tritos .

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Editors and Affiliations

  1. Massachusetts General Hospital, Dept. Neurosurgery, Harvard Medical School, Parkman St. 15, Boston, 02114, Massachusetts, USA

    Brooke Swearingen

  2. Neuroendocrine Clinical Centre, Massachusetts General Hospital, Fruit St. 55, Boston, 02114, Massachusetts, USA

    Beverly M. K. Biller

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Tritos, N.A., Biller, B.M.K. (2011). Cyclic Cushing’s Disease. In: Swearingen, B., Biller, B. (eds) Cushing's Disease. Endocrine Updates, vol 31. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-0011-0_6

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  • DOI: https://doi.org/10.1007/978-1-4614-0011-0_6

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