"Subclinical Cushing's syndrome" is not subclinical: improvement after adrenalectomy in 9 patients

Ian C. Mitchell, Richard J. Auchus, Kavita Juneja, Alice Y Chang, Shelby A. Holt, William H. Snyder, Fiemu E. Nwariaku

Research output: Contribution to journalArticle

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Abstract

Background: A subgroup of patients with adrenal cortisol hypersecretion fails to meet the biochemical criteria for Cushing's syndrome. Appropriate therapy for this entity, subclinical Cushing's syndrome (subclinical CS), is unclear. We examined outcomes for patients who underwent unilateral adrenalectomy for subclinical CS. Methods: Between 2003 and 2006, all patients who underwent adrenalectomy for cortisol hypersecretion caused by an adrenal mass were examined. We analyzed biochemical, metabolic, and clinical outcomes. Results: Overall, 24 patients underwent adrenalectomy for adrenal cortisol hypersecretion, of which 9 were found to have subclinical CS. Median serum cortisol was 2.0 μg/dL (range, 1.1-6.1) after 1-mg overnight dexamethasone suppression testing. Suspicious clinical findings on preoperative examination included skin bruising, unexplained weight gain, proximal muscle weakness, abnormal fat pads, skin thinning, fatigue, and facial plethora. During a median follow-up period of 5 months (range, 1-30 months), all 8 patients with easy bruising noted resolution postoperatively. Fatigue improved in 4 of 5 patients, muscle weakness in 6 of 8 patients, and weight in 7 of 9 patients, with a median body mass index change of -2.0 kg/m2 (range, -7.1 to +0.5 kg/m2). Conclusion: Adrenalectomy improves clinical and metabolic parameters for many patients with subclinical CS.

Original languageEnglish (US)
Pages (from-to)900-905
Number of pages6
JournalSurgery
Volume142
Issue number6
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Cushing Syndrome
Adrenalectomy
Hydrocortisone
Muscle Weakness
Fatigue
Skin
Dexamethasone
Weight Gain
Adipose Tissue
Body Mass Index
Weights and Measures

ASJC Scopus subject areas

  • Surgery

Cite this

Mitchell, I. C., Auchus, R. J., Juneja, K., Chang, A. Y., Holt, S. A., Snyder, W. H., & Nwariaku, F. E. (2007). "Subclinical Cushing's syndrome" is not subclinical: improvement after adrenalectomy in 9 patients. Surgery, 142(6), 900-905. https://doi.org/10.1016/j.surg.2007.10.001

"Subclinical Cushing's syndrome" is not subclinical : improvement after adrenalectomy in 9 patients. / Mitchell, Ian C.; Auchus, Richard J.; Juneja, Kavita; Chang, Alice Y; Holt, Shelby A.; Snyder, William H.; Nwariaku, Fiemu E.

In: Surgery, Vol. 142, No. 6, 12.2007, p. 900-905.

Research output: Contribution to journalArticle

Mitchell, IC, Auchus, RJ, Juneja, K, Chang, AY, Holt, SA, Snyder, WH & Nwariaku, FE 2007, '"Subclinical Cushing's syndrome" is not subclinical: improvement after adrenalectomy in 9 patients', Surgery, vol. 142, no. 6, pp. 900-905. https://doi.org/10.1016/j.surg.2007.10.001
Mitchell, Ian C. ; Auchus, Richard J. ; Juneja, Kavita ; Chang, Alice Y ; Holt, Shelby A. ; Snyder, William H. ; Nwariaku, Fiemu E. / "Subclinical Cushing's syndrome" is not subclinical : improvement after adrenalectomy in 9 patients. In: Surgery. 2007 ; Vol. 142, No. 6. pp. 900-905.
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