Endocrine

, Volume 47, Issue 1, pp 9–20 | Cite as

Managing Cushing’s disease: the state of the art

  • Annamaria Colao
  • Marco Boscaro
  • Diego Ferone
  • Felipe F. Casanueva
Review

Abstract

Cushing’s disease is a rare chronic disease caused by a pituitary adenoma, which leads to excess secretion of adrenocorticotropic hormone (ACTH). The over-production of ACTH leads to hyperstimulation of the adrenal glands and a chronic excess of cortisol, resulting in the signs and symptoms of a severe clinical state (Cushing’s syndrome) that leads to significant morbidity, negative impacts on the patient’s quality of life, and, if untreated, increased mortality. The management of patients with Cushing’s disease is complicated by the heterogeneity of the condition, with signs and symptoms that overlap with those of other diseases, and high subclinical incidence rates. Controversies surrounding the tests used for screening and identifying patients with Cushing’s disease add to the challenge of patient management. Surgical intervention to remove the adenoma is the first-line treatment for patients with Cushing’s disease, but medical therapies are useful in patients who relapse or are unsuitable for surgery. The recent introduction of pasireotide, the first pituitary-directed medical therapy, expands the number of treatment options available for patients with Cushing’s disease. This state-of-the-art review aims to provide an overview of the most recent scientific research and clinical information regarding Cushing’s disease. Continuing research into improving the diagnosis and treatment of Cushing’s disease will help to optimize patient management.

Keywords

Cushing’s disease ACTH Cortisol Pituitary Management 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Annamaria Colao
    • 1
  • Marco Boscaro
    • 2
  • Diego Ferone
    • 3
  • Felipe F. Casanueva
    • 4
    • 5
  1. 1.Dipartimento di Medicina Clinica e ChirurgiaUniversità Federico II di NapoliNaplesItaly
  2. 2.Division of Endocrinology and MetabolismUniversity Politecnica delle MarcheAnconaItaly
  3. 3.Endocrinology, Department of Internal Medicine and Medical Specialties and Center of Excellence for Biomedical Research, IRCCS-AOU San Martino-ISTUniversity of GenoaGenoaItaly
  4. 4.Department of MedicineSantiago de Compostela UniversitySantiago de CompostelaSpain
  5. 5.CIBER Obesity and NutritionInstitute of Health Carlos IIIMadridSpain

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