Subclinical Cushing’s syndrome: lots of questions — little answers

The literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex ade...

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Autor principal:	S.І. Rybakov
Formato:	article
Lenguaje:	EN RU UK
Publicado:	Publishing House Zaslavsky 2021
Materias:	subclinical cushing’s syndrome, frequency, diagnosis, treatment, review Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/c49a24aeb0b94824a9ca4a6b524a9784
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spelling	oai:doaj.org-article:c49a24aeb0b94824a9ca4a6b524a97842021-11-22T11:26:20ZSubclinical Cushing’s syndrome: lots of questions — little answers2224-07212307-142710.22141/2224-0721.17.6.2021.243216https://doaj.org/article/c49a24aeb0b94824a9ca4a6b524a97842021-10-01T00:00:00Zhttp://iej.zaslavsky.com.ua/article/view/243216https://doaj.org/toc/2224-0721https://doaj.org/toc/2307-1427The literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex adenoma, suppression of the adrenocorticotropic function of the pituitary gland and the functional state of the opposite adrenal gland. Such a condition may be clinically asymptomatic or be accompanied by some nonspecific signs of hypercortisolism (arterial hypertension, diabetes mellitus, obesity, osteoporosis). Noteworthy is the large variability in the frequency of its detection, which is possibly due to the use of various criteria for assigning individual cases to this category. As a basic screening test for the detection of subclinical hypercortisolism, most researchers consider the most acceptable and effective night suppressive test with 1.0 mg of dexamethasone. Modern tactical and technical approaches to the treatment of subclinical Cushing’s syndrome are quite diverse and are more often based on pragmatic principles than on reliably substantiated ones. The author raises the question: could subclinical Cushing’s syndrome be the result of hyperfunction of normal or diffusely enlarged (hyperplastic) adrenal glands as a result of some disturbances in the hypothalamic-pituitary-adrenal hierarchy. And, finally, are the disorders “accompanying” subclinical Cushing’s syndrome a consequence of the overproduction of cortisol, although often insignificant, or can they be the cause of the onset of subclinical hypercortisolism? For the treatment of subclinical hypercortisolism, adrenalectomy is currently proposed, with the aim of reducing the intake of excessive amounts of glucocorticoids into the patient’s body, leading to the development of these disorders. Known drug methods of suppressing the function of the adrenal cortex — drugs chloditan, mitotane, ketoconazole.S.І. RybakovPublishing House Zaslavskyarticlesubclinical cushing’s syndrome, frequency, diagnosis, treatment, reviewDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENRUUKMìžnarodnij Endokrinologìčnij Žurnal, Vol 17, Iss 6, Pp 503-512 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU UK
topic	subclinical cushing’s syndrome, frequency, diagnosis, treatment, review Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	subclinical cushing’s syndrome, frequency, diagnosis, treatment, review Diseases of the endocrine glands. Clinical endocrinology RC648-665 S.І. Rybakov Subclinical Cushing’s syndrome: lots of questions — little answers
description	The literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex adenoma, suppression of the adrenocorticotropic function of the pituitary gland and the functional state of the opposite adrenal gland. Such a condition may be clinically asymptomatic or be accompanied by some nonspecific signs of hypercortisolism (arterial hypertension, diabetes mellitus, obesity, osteoporosis). Noteworthy is the large variability in the frequency of its detection, which is possibly due to the use of various criteria for assigning individual cases to this category. As a basic screening test for the detection of subclinical hypercortisolism, most researchers consider the most acceptable and effective night suppressive test with 1.0 mg of dexamethasone. Modern tactical and technical approaches to the treatment of subclinical Cushing’s syndrome are quite diverse and are more often based on pragmatic principles than on reliably substantiated ones. The author raises the question: could subclinical Cushing’s syndrome be the result of hyperfunction of normal or diffusely enlarged (hyperplastic) adrenal glands as a result of some disturbances in the hypothalamic-pituitary-adrenal hierarchy. And, finally, are the disorders “accompanying” subclinical Cushing’s syndrome a consequence of the overproduction of cortisol, although often insignificant, or can they be the cause of the onset of subclinical hypercortisolism? For the treatment of subclinical hypercortisolism, adrenalectomy is currently proposed, with the aim of reducing the intake of excessive amounts of glucocorticoids into the patient’s body, leading to the development of these disorders. Known drug methods of suppressing the function of the adrenal cortex — drugs chloditan, mitotane, ketoconazole.
format	article
author	S.І. Rybakov
author_facet	S.І. Rybakov
author_sort	S.І. Rybakov
title	Subclinical Cushing’s syndrome: lots of questions — little answers
title_short	Subclinical Cushing’s syndrome: lots of questions — little answers
title_full	Subclinical Cushing’s syndrome: lots of questions — little answers
title_fullStr	Subclinical Cushing’s syndrome: lots of questions — little answers
title_full_unstemmed	Subclinical Cushing’s syndrome: lots of questions — little answers
title_sort	subclinical cushing’s syndrome: lots of questions — little answers
publisher	Publishing House Zaslavsky
publishDate	2021
url	https://doaj.org/article/c49a24aeb0b94824a9ca4a6b524a9784
work_keys_str_mv	AT sírybakov subclinicalcushingssyndromelotsofquestionslittleanswers
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Subclinical Cushing’s syndrome: lots of questions — little answers

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