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Sindrome di Cushing: forme atipiche

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Riassunto

La sindrome di Cushing può essere ACTH-dipendente o ACTH-indipendente ed ha una incidenza compresa fra 0,7 e 2,4/1.000.000 per anno. Il quadro clinico generalmente presenta manifestazioni “tipiche”, ma esse possono essere presenti con una frequenza e in combinazioni così variabili, tali da rendere la diagnosi difficoltosa. Esistono, tuttavia, quadri cosiddetti “atipici” talora correlati alle particolari età in cui si manifestano, ma, il più delle volte legati alle specifiche cause patogenetiche sottostanti. In questo articolo si intende richiamare l’attenzione sia del medico pratico, sia dello specialista, su alcuni quadri clinici particolari e su alcuni aspetti patogenetici peculiari (sia ACTH-dipendenti, sia ACTH-indipendenti), che sottendono la possibile presenza di una sindrome di Cushing.

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Bibliografia

  1. Desai N, Kapoor A, Singh BK, Liu J. Bilateral adrenal adenomas and persistent leukocytosis: a unique case of Cushing’s syndrome. Am J Med 119: e3, 2006.

    Article  PubMed  Google Scholar 

  2. Gursoy A, Dogruk Unal A, Ayturk S, Karakus S, Nur Izol A, Bascil Tutuncu N, Guvener Demirag N. Polycythemia as the first manifestation of Cushing’s disease. J Endocrinol Invest 29: 742, 2006.

    CAS  PubMed  Google Scholar 

  3. Magiakou MA, Chrousos GP. Cushing’s syndrome in children and adolescents: current diagnostic and therapeutic strategies. J Endocrinol Invest 25: 181, 2002.

    CAS  PubMed  Google Scholar 

  4. Storr HL, Isidori AM, Monson JP, Besser GM, Grossman AB, Savage MO. Prepubertal Cushing’s disease is more common in males, but there is no increase in severity at diagnosis. J Clin Endocrinol Metab 89: 3818, 2004.

    Article  CAS  PubMed  Google Scholar 

  5. Stratakis CA, Kirschner LS, Carney JA. Clinical and molecular features of the Carney complex: diagnostic criteria and recommendations for patient evaluation. J Clin Endocrinol Metab 86: 4041, 2001.

    Article  CAS  PubMed  Google Scholar 

  6. Lindsay JR, Nieman LK. The hypothalamic-pituitary-adrenal axis in pregnancy: challenges in disease detection and treatment. Endocr Rev 26: 775, 2005.

    Article  CAS  PubMed  Google Scholar 

  7. Walker AB, Leese GP, Vora JP. Diagnostic difficulties in periodic Cushing’s syndrome. Postgrad Med J 73: 426, 1997.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Lacroix A, Baldacchino V, Bordeau I, Hamet P, Tremblay J. Cushing’s syndrome variants secondary to aberrant hormone receptors. Trends Endocrinol Metab 15: 375, 2004.

    Article  CAS  PubMed  Google Scholar 

  9. Dall’Asta C, Ballarè E, Mantovani G, Ambrosi B, Spada A, Barbetta L, Colombo P, Travaglini P, Loli P, Beck-Peccoz P. Assessing the presence of abnormal regulation of cortisol secretion by membrane hormone receptors: in vivo and in vitro studies in patients with functioning and non-functioning adrenaladenoma. Horm Metab Res 36: 578, 2004.

    Article  PubMed  Google Scholar 

  10. Barzon L, Sonino N, Fallo F, Palù G, Boscaro M. Prevalence and natural history of adrenal incidentalomas. Eur J Endocrinol 149: 273, 2003.

    Article  CAS  PubMed  Google Scholar 

  11. Tauchmanovà L, Rossi R, Biondi B, Pulcrano M, Nuzzo V, Calmieri EA, Fazio S, Lombardi G. Patients with subclinical Cushing’s syndrome due to adrenal adenoma have increased cardiovascular risk. J Clin Endocrinol Metab 87: 4872, 2002.

    Article  PubMed  Google Scholar 

  12. Chiodini I, Guglielmi G, Battista C, Carnevale V, Torlontano M, Cammisa M, Trischitta V, Scillitani A. Spinal volumetric bone mineral density and vertebral fractures in female patients with adrenal incidentalomas: the effects of subclinical hypercortisolism and gonadal status. J Clin Endocrinol Metab 89: 2237, 2004.

    Article  CAS  PubMed  Google Scholar 

  13. Chiodini I, Torlontano M, Scillitani A, Arosio M, Bacci S, Di Lembo S, Epaminonda P, Augello G, Enrini R, Ambrosi B, Adda G, Trischitta V. Association of subclinical hypercortisolism with type 2 diabetes mellitus: a case-control study in hospitalized patients. Eur J Endocrinol 153: 837, 2005.

    Article  CAS  PubMed  Google Scholar 

  14. Terzolo M, Bovio S, Pia A, Conton PA, Reimondo G, Dall’Asta C, Bemporad D, Angeli A, Opocher G, Mannelli M, Ambrosi B, Mantero F. Midnight serum cortisol as a marker of increased cardiovascular risk in patients with a clinically inapparent adrenal adenoma. Eur J Endocrinol 153: 307, 2005.

    Article  CAS  PubMed  Google Scholar 

  15. Midorikawa S, Sanada H, Hashimoto S, Suzuki T, Watanabe T. The improvement of insulin resistance in patients with adrenal incidentaloma by surgical resection. Clin Endocrinol 54: 797, 2001.

    Article  CAS  Google Scholar 

  16. Barzon L, Fallo F, Sonino N, Boscaro M. Development of overt Cushing’s syndrome in patients with adrenal incidentaloma. Eur J Endocrinol 146: 61, 2002.

    Article  CAS  PubMed  Google Scholar 

  17. Komiya I, Takasu N, Aizawa T, Yamada T, Koizumi Y, Hashizume K, Ishihara M, Hiramatsu K, Ichikawa K, Katakura M, Kobayashi M, Yamauchi K, Yanagisawa K, Naka M, Miyamoto T. Black (or brown) adrenal cortical adenoma: its characteristic features on computed tomography and endocrine data. J Clin Endocrinol Metab 61: 711, 1985.

    Article  CAS  PubMed  Google Scholar 

  18. Ambrosi B, Colombo P, Faglia G. Cushing’s syndrome due to a black adenoma of the adrenal gland: lack of tumour visualization by radiocholesterol scintigraphy. Eur J Nucl Med 21: 1367, 1994.

    Article  CAS  PubMed  Google Scholar 

  19. Ambrosi B, Colombo P, Bochicchio D, Bassetti M, Masini B, Faglia G. The silent corticotropinoma: is clinical diagnosis possibile? J Endocrinol Invest 15: 443, 1992.

    CAS  PubMed  Google Scholar 

  20. Tan EU, Ho MSJ, Rajasoorya CR. Metamorphosis of a non-functioning pituitary adenoma to Cushing’s disease. Pituitary 3: 117, 2000.

    Article  CAS  PubMed  Google Scholar 

  21. Woo YS, Isidori AM, Wat WZ, Kaltsas GA, Afshar F, Sabin I, Jenkins PJ, Monson JP, Besser GM, Grossman AB. Clinical and biochemical characteristics of adrenocorticotropin-secreting macroadenomas. J Clin Endocrinol Metab 90: 4963, 2005.

    Article  CAS  PubMed  Google Scholar 

  22. Cazabat L, Ragazzon B, Groussin L, Bertherat J. PRKAR1A mutations in primary pigmented nodular adrenocortical disesae. Pituitary 9: 211, 2006.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Scienze Medico-Chirurgiche, Università degli Studi di Milano, U.O. Endocrinologia, IRCCS Policlinico San Donato (MI), Via Morandi 30, 20097, San Donato Milanese (MI), Italia

    Sabrina Corbetta, Federica Ermetici &  Bruno Ambrosi

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  1. Sabrina Corbetta
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  2. Federica Ermetici
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  3. Bruno Ambrosi
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Correspondence to Bruno Ambrosi.

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Corbetta, S., Ermetici, F. & Ambrosi, B. Sindrome di Cushing: forme atipiche. L’Endocrinologo 9, 3–13 (2008). https://doi.org/10.1007/BF03344598

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