Evang Johan Arild, Carlsen Sven M, Svartberg Johan, Aanderud Sylvi, Johannesen Øivind, Schreiner Thomas, Ramm-Pettersen Jon, Bakke Søren Jacob, Lund-Johansen Morten, Bollerslev Jens
Endokrinologisk seksjon, Medisinsk avdeling, Rikshospitalet, 0027 Oslo.
Tidsskr Nor Laegeforen. 2006 Feb 23;126(5):599-602.
Untreated endogenous Cushing's syndrome is a serious condition with high morbidity and mortality. New diagnostic procedures make today's assessment more accurate. We describe which tests should be done when there is suspicion of the syndrome. Treatment options are mentioned.
The paper is based on current international literature and reflects the experience of the authors.
Endogenous Cushing's syndrome is caused by elevated cortisol levels. The reason can be overproduction of ACTH or an adrenocortical pathology. It should be considered when combinations of symptoms like central obesity, proximal muscle weakness, striae and menstrual irregularities are seen. Osteoporosis and impotence are other important symptoms. Diagnosis of Cushing's syndrome is often challenging. Measurement of urinary free cortisol or overnight dexamethasone suppression test has usually been performed initially. Midnight salivary cortisol seems promising as an alternative. The final diagnosis is often made after a combined evaluation of dynamic tests. The first-line treatment of endogenous Cushing's syndrome is surgery.
未经治疗的内源性库欣综合征是一种严重疾病，发病率和死亡率都很高。新的诊断程序使如今的评估更加准确。我们描述了在怀疑患有该综合征时应进行哪些检查，并提及了治疗方案。
本文基于当前国际文献，并反映了作者的经验。
内源性库欣综合征由皮质醇水平升高引起。原因可能是促肾上腺皮质激素分泌过多或肾上腺皮质病变。当出现如向心性肥胖、近端肌无力、皮肤紫纹和月经不调等症状组合时，应考虑该病。骨质疏松和阳痿是其他重要症状。库欣综合征的诊断通常具有挑战性。通常最初会进行尿游离皮质醇测定或过夜地塞米松抑制试验。午夜唾液皮质醇作为一种替代方法似乎很有前景。最终诊断通常在对动态试验进行综合评估后做出。内源性库欣综合征的一线治疗方法是手术。
