Conget J I, Halperin I, Vendrell J, Ferrer J, Martínez-Osaba M J, Esmatjes E, Vilardell E
Med Clin (Barc). 1989 Nov 4;93(14):531-4.
The effectiveness of ketoconazole for the therapy of Cushing's syndrome, both of adrenal and pituitary origin, was retrospectively evaluated. To this end, the clinical and hormonal results in 5 patients were assessed. There were 4 females and one male, with ages ranging between 17 and 64 years. Three of them, who had Cushing's disease, received sustained treatment with ketoconazole when other therapeutic measures had failed. The two remaining patients (one with Cushing's disease and the other with adrenal adenoma) were treated with this drug in the preoperative period to alleviate the deterioration in the clinical condition caused by hypercortisolism. The clinical evolution of the patients is described, as well as the plasma adrenocorticotropin (ACTH) and the free cortisol in 24 hour urine in the subsequent controls. In view of the study results, we feel that ketoconazole is an effective treatment for the long term control of Cushing's syndrome. In addition, it may be also useful as preoperative therapy in those patients severely deteriorated by the sustained hypercortisolism.
我们回顾性评估了酮康唑治疗肾上腺源性和垂体源性库欣综合征的有效性。为此,我们评估了5例患者的临床和激素结果。其中有4名女性和1名男性,年龄在17至64岁之间。他们中有3例患有库欣病,在其他治疗措施失败后接受了酮康唑的持续治疗。其余2例患者(1例患有库欣病,另1例患有肾上腺腺瘤)在术前接受了该药治疗,以缓解高皮质醇血症引起的临床状况恶化。本文描述了患者的临床病程,以及后续检查中血浆促肾上腺皮质激素(ACTH)和24小时尿游离皮质醇的情况。鉴于研究结果,我们认为酮康唑是长期控制库欣综合征的有效治疗方法。此外,对于因持续性高皮质醇血症而严重恶化的患者,它也可能作为术前治疗有用。