Subclinical Cushing's syndrome: Definition and management

Clinical Endocrinology

Volumn 76, Issue 1, 2012, Pages 12-18

  Terzolo, M ^a   Pia, A ^a   Reimondo, G ^a  

^a UNIVERSITY OF TURIN   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

DEXAMETHASONE; HYDROCORTISONE;

ADRENAL CORTEX ADENOMA; ADRENALECTOMY; COMORBIDITY; CONSERVATIVE TREATMENT; CUSHING SYNDROME; DEXAMETHASONE SUPPRESSION TEST; DISEASE COURSE; HUMAN; HYDROCORTISONE BLOOD LEVEL; HYDROCORTISONE URINE LEVEL; HYPERCORTISOLISM; HYPOPHYSIS ADENOMA; LOW DRUG DOSE; METABOLIC SYNDROME X; PRIORITY JOURNAL; REVIEW;

ADRENALECTOMY; HUMANS; PITUITARY ACTH HYPERSECRETION;

EID: 83455200170     PISSN: 03000664     EISSN: 13652265     Source Type: Journal    
DOI: 10.1111/j.1365-2265.2011.04253.x     Document Type: Review

References (65)

1. Ross, N.S., (1994) Epidemiology of Cushing's syndrome and subclinical disease. Endocrinology and Metabolism Clinics of North America, 23, 539-546. (Pubitemid 24300124)
2. Reincke, M., (2000) Subclinical Cushing's syndrome. Endocrinology and Metabolism Clinics of North America, 29, 43-56. (Pubitemid 30151888)
3. Grumbach, M.M., Biller, B.M., Braunstein, G.D., et al. (2003) Management of the clinically inapparent adrenal mass ('incidentaloma'). Annals of Internal Medicine, 138, 424-429. (Pubitemid 36262654)
4. Zeiger, M.A., Thompson, G.B., Duh, Q.Y., et al. (2009) The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocrine Practice, 15 (Suppl. 1), 1-20.
5. Kloos, R.T., Gross, M.D., Francis, I.R., et al. (1995) Incidentally discovered adrenal masses. Endocrine Reviews, 16, 460-484.
6. Mantero, F., Terzolo, M., Arnaldi, G., et al. (2000) A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. Journal of Clinical Endocrinology and Metabolism, 85, 637-644.
7. Barzon, L., Sonino, N., Fallo, F., et al. (2003) Prevalence and natural history of adrenal incidentalomas. European Journal of Endocrinology, 149, 273-285. (Pubitemid 37304697)
8. Terzolo, M., Bovio, S., Reimondo, G., et al. (2005) Subclinical Cushing's syndrome in adrenal incidentalomas. Endocrinology and Metabolism Clinics of North America, 34, 423-439. (Pubitemid 40602730)
9. Young, W.F. Jr., (2007) Clinical practice. The incidentally discovered adrenal mass. New England Journal of Medicine, 356, 601-610. (Pubitemid 46220820)
10. Cawood, T.J., Hunt, P.J., O'Shea, D., et al. (2009) Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink? European Journal of Endocrinology, 161, 513-527.
11. Nieman, L.K., Biller, B.M., Findling, J.W., et al. (2008) The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism, 93, 1526-1540. (Pubitemid 351656485)
12. Stewart, P.M., (2010) Is subclinical Cushing's syndrome an entity or a statistical fallout from diagnostic testing? Consensus surrounding the diagnosis is required before optimal treatment can be defined Journal of Clinical Endocrinology and Metabolism, 95, 2618-2620.
13. Catargi, B., Rigalleau, V., Poussin, A., et al. (2003) Occult Cushing's syndrome in type-2 diabetes. Journal of Clinical Endocrinology and Metabolism, 88, 5808-5813. (Pubitemid 38033055)
14. Chiodini, I., Torlontano, M., Scillitani, A., et al. (2005) Association of subclinical hypercortisolism with type 2 diabetes mellitus: a case-control study in hospitalized patients. European Journal of Endocrinology, 153, 837-844. (Pubitemid 43020234)
15. Liu, H., Bravata, D.M., Cabaccan, J., et al. (2005) Elevated late-night salivary cortisol levels in elderly male type 2 diabetic veterans. Clinical Endocrinology (Oxford), 63, 642-649. (Pubitemid 41779637)
16. Reimondo, G., Pia, A., Allasino, B., et al. (2007) Screening of Cushing's syndrome in adult patients with newly diagnosed diabetes mellitus. Clinical Endocrinology (Oxford), 67, 225-229. (Pubitemid 47076296)
17. Chiodini, I., Mascia, M.L., Muscarella, S., et al. (2007) Subclinical hypercortisolism among outpatients referred for osteoporosis. Annals of Internal Medicine, 147, 541-548. (Pubitemid 351664501)
18. Mullan, K., Black, N., Thiraviaraj, A., et al. (2010) Is there value in routine screening for Cushing's syndrome in patients with diabetes? Journal of Clinical Endocrinology and Metabolism, 95, 2262-2265.
19. Barzon, L., Fallo, F., Sonino, N., et al. (2001) Overnight dexamethasone suppression of cortisol is associated with radiocholesterol uptake patterns in adrenal incidentalomas. European Journal of Endocrinology, 145, 223-224. (Pubitemid 32707610)
20. Valli, N., Catargi, B., Ronci, N., et al. (2001) Biochemical screening for subclinical cortisol-secreting adenomas amongst adrenal incidentalomas. European Journal of Endocrinology, 144, 401-408. (Pubitemid 32409594)
21. Eller-Vainicher, C., Morelli, V., Salcuni, A.S., et al. (2010) Post-surgical hypocortisolism after removal of an adrenal incidentaloma: is it predictable by an accurate endocrinological work-up before surgery? European Journal of Endocrinology, 162, 91-99.
22. Eller-Vainicher, C., Morelli, V., Salcuni, A.S., et al. (2010) Accuracy of several parameters of hypothalamic-pituitary-adrenal axis activity in predicting before surgery the metabolic effects of the removal of an adrenal incidentaloma. European Journal of Endocrinology, 163, 925-935.
23. Tabarin, A., Bardet, S., Bertherat, J., et al. (2008) Exploration and management of adrenal incidentalomas. French Society of Endocrinology Consensus. Annales d'endocrinologie, 69, 487-500.
24. Reincke, M., Nieke, J., Krestin, G.P., et al. (1992) Preclinical Cushing's syndrome in adrenal 'incidentalomas': comparison with adrenal Cushing's syndrome. Journal of Clinical Endocrinology and Metabolism, 75, 826-832.
25. Kasperlik-Zeluska, A.A., Roslonowska, E., Slowinska-Srzednicka, J., et al. (1997) Incidentally discovered adrenal mass (incidentaloma): investigation and management of 208 patients. Clinical Endocrinology (Oxford), 46, 29-37. (Pubitemid 27072843)
26. Tanabe, A., Naruse, M., Nishikawa, T., et al. (2001) Autonomy of cortisol secretion in clinically silent adrenal incidentaloma. Hormone and Metabolic Research, 33, 444-450. (Pubitemid 32721529)
27. Katabami, T., Obi, R., Shirai, N., et al. (2005) Discrepancies in results of low-and high-dose dexamethasone suppression tests for diagnosing preclinical Cushing's syndrome. Endocrine Journal, 52, 463-469. (Pubitemid 41380557)
28. Reimondo, G., Allasino, B., Bovio, S., et al. (2011) Pros and cons of dexamethasone suppression test for screening of subclinical Cushing's syndrome in patients with adrenal incidentalomas. Journal of Endocrinological Investigation, 34, e1-e5.
29. Tsagarakis, S., Roboti, C., Kokkoris, P., et al. (1998) Elevated post-dexamethasone suppression cortisol concentrations correlate with hormonal alterations of the hypothalamo-pituitary adrenal axis in patients with adrenal incidentalomas. Clinical Endocrinology (Oxford), 49, 165-171. (Pubitemid 28372643)
30. Tauchmanova, L., Rossi, R., Biondi, B., et al. (2002) Patients with subclinical Cushing's syndrome due to adrenal adenoma have increased cardiovascular risk. Journal of Clinical Endocrinology and Metabolism, 87, 4872-4878. (Pubitemid 35316318)
31. Arnaldi, G., Angeli, A., Atkinson, A.B., et al. (2003) Diagnosis and complications of Cushing's syndrome: a consensus statement. Journal of Clinical Endocrinology and Metabolism, 88, 5593-5602. (Pubitemid 38033020)
32. Raff, H., &, Findling, J.W., (2003) A physiologic approach to diagnosis of the Cushing syndrome. Annals of Internal Medicine, 138, 980-991. (Pubitemid 38129119)
33. Tsagarakis, S., Vassiliadi, D., &, Thalassinos, N., (2006) Endogenous subclinical hypercortisolism: diagnostic uncertainties and clinical implications. Journal of Endocrinological Investigation, 29, 471-482. (Pubitemid 44043366)
34. Pecori Giraldi, F., Saccani, A., Cavagnini, F., et al. (2011) Assessment of ACTH assay variability: a multicenter study. European Journal of Endocrinology, 164, 505-512.
35. Reimondo, G., Pia, A., Bovio, S., et al. (2008) Laboratory differentiation of Cushing's syndrome. Clinica Chimica Acta, 388, 5-14. (Pubitemid 350266593)
36. Terzolo, M., Bovio, S., Pia, A., et al. (2005) Midnight serum cortisol as a marker of increased cardiovascular risk in patients with a clinically inapparent adrenal adenoma. European Journal of Endocrinology, 153, 307-315. (Pubitemid 41167489)
37. Masserini, B., Morelli, V., Bergamaschi, S., et al. (2009) The limited role of midnight salivary cortisol levels in the diagnosis of subclinical hypercortisolism in patients with adrenal incidentaloma. European Journal of Endocrinology, 160, 87-92.
38. Nunes, M.L., Vattaut, S., Corcuff, J.B., et al. (2009) Late-night salivary cortisol for diagnosis of overt and subclinical Cushing's syndrome in hospitalized and ambulatory patients. Journal of Clinical Endocrinology and Metabolism, 94, 456-462.
39. Kidambi, S., Raff, H., &, Findling, J.W., (2007) Limitations of nocturnal salivary cortisol and urine free cortisol in the diagnosis of mild Cushing's syndrome. European Journal of Endocrinology, 157, 725-731.
40. Sereg, M., Toke, J., Patocs, A., et al. (2011) Diagnostic performance of salivary cortisol and serum osteocalcin measurements in patients with overt and subclinical Cushing's syndrome. Steroids, 76, 38-42.
41. Gagliardi, L., &, Torpy, D.J., (2010) Subclinical Cushing's syndrome in adrenal incidentaloma: a common problem or an artefact of current diagnostic testing? Clinical Endocrinology (Oxford), 72, 277-278.
42. Libe, R., Dall'Asta, C., Barbetta, L., et al. (2002) Long-term follow-up study of patients with adrenal incidentalomas. European Journal of Endocrinology, 147, 489-494. (Pubitemid 35238144)
43. Terzolo, M., Osella, G., Ali, A., et al. (1998) Subclinical Cushing's syndrome in adrenal incidentaloma. Clinical Endocrinology (Oxford), 48, 89-97. (Pubitemid 28122438)
44. Ambrosi, B., Peverelli, S., Passini, E., et al. (1995) Abnormalities of endocrine function in patients with clinically 'silent' adrenal masses. European Journal of Endocrinology, 132, 422-428.
45. Grossrubatscher, E., Vignati, F., Possa, M., et al. (2001) The natural history of incidentally discovered adrenocortical adenomas: a retrospective evaluation. Journal of Endocrinological Investigation, 24, 846-855. (Pubitemid 34036714)
46. Chiodini, I., Morelli, V., Salcuni, A.S., et al. (2010) Beneficial metabolic effects of prompt surgical treatment in patients with an adrenal incidentaloma causing biochemical hypercortisolism. Journal of Clinical Endocrinology and Metabolism, 95, 2736-2745.
47. Terzolo, M., Stigliano, A., Chiodini, I., et al. (2011) AME Position Statement on adrenal incidentaloma. European Journal of Endocrinology, 164, 851-870.
48. Lal, G., &, Duh, Q.Y., (2003) Laparoscopic adrenalectomy-indications and technique. Surgical Oncology, 12, 105-123. (Pubitemid 37289016)
49. Aron, D.C., (2001) The adrenal incidentaloma: disease of modern technology and public health problem. Reviews in Endocrine and Metabolic Disorders, 2, 335-342. (Pubitemid 33640582)
50. Angeli, A., &, Terzolo, M., (2002) Adrenal incidentaloma-a modern disease with old complications. Journal of Clinical Endocrinology and Metabolism, 87, 4869-4871. (Pubitemid 35316317)
51. Chiodini, I., Morelli, V., Masserini, B., et al. (2009) Bone mineral density, prevalence of vertebral fractures, and bone quality in patients with adrenal incidentalomas with and without subclinical hypercortisolism: an Italian multicenter study. Journal of Clinical Endocrinology and Metabolism, 94, 3207-3214.
52. Chiodini, I., Viti, R., Coletti, F., et al. (2009) Eugonadal male patients with adrenal incidentalomas and subclinical hypercortisolism have increased rate of vertebral fractures. Clinical Endocrinology (Oxford), 70, 208-213.
53. Giordano, R., Marinazzo, E., Berardelli, R., et al. (2010) Long-term morphological, hormonal, and clinical follow-up in a single unit on 118 patients with adrenal incidentalomas. European Journal of Endocrinology, 162, 779-785.
54. Terzolo, M., Pia, A., Ali, A., et al. (2002) Adrenal incidentaloma: a new cause of the metabolic syndrome? Journal of Clinical Endocrinology and Metabolism, 87, 998-1003. (Pubitemid 36121054)
55. Bernini, G.P., Moretti, A., Oriandini, C., et al. (2005) Long-term morphological and hormonal follow-up in a single unit on 115 patients with adrenal incidentalomas. British Journal of Cancer, 92, 1104-1109. (Pubitemid 40546676)
56. Siren, J., Tervahartiala, P., Sivula, A., et al. (2000) Natural course of adrenal incidentalomas: seven-year follow-up study. World Journal of Surgery 24, 579-582. (Pubitemid 30210849)
57. Barzon, L., Scaroni, C., Sonino, N., et al. (1999) Risk factors and long-term follow-up of adrenal incidentalomas. Journal of Clinical Endocrinology and Metabolism, 84, 520-526. (Pubitemid 29075678)
58. Emral, R., Uysal, A.R., Asik, M., et al. (2003) Prevalence of subclinical Cushing's syndrome in 70 patients with adrenal incidentaloma: clinical, biochemical and surgical outcomes. Endocrine Journal, 50, 399-408. (Pubitemid 37129032)
59. Midorikawa, S., Sanada, H., Hashimoto, S., et al. (2001) The improvement of insulin resistance in patients with adrenal incidentaloma by surgical resection. Clinical Endocrinology (Oxford), 54, 797-804. (Pubitemid 34208891)
60. Mitchell, I.C., Auchus, R.J., Juneja, K., et al. (2007) 'Subclinical Cushing's syndrome' is not subclinical: improvement after adrenalectomy in 9 patients. Surgery, 142, 900-905, Discussion 905 e901. (Pubitemid 350184118)
61. Erbil, Y., Ademoglu, E., Ozbey, N., et al. (2006) Evaluation of the cardiovascular risk in patients with subclinical Cushing syndrome before and after surgery. World Journal of Surgery, 30, 1665-1671. (Pubitemid 44411221)
62. Toniato, A., Merante-Boschin, I., Opocher, G., et al. (2009) Surgical versus conservative management for subclinical Cushing syndrome in adrenal incidentalomas: a prospective randomized study. Annals of Surgery, 249, 388-391.
63. Sereg, M., Szappanos, A., Toke, J., et al. (2009) Atherosclerotic risk factors and complications in patients with non-functioning adrenal adenomas treated with or without adrenalectomy: a long-term follow-up study. European Journal of Endocrinology, 160, 647-655.
64. Iacobone, M., Mantero, F., Basso, S.M., et al. (2005) Results and long-term follow-up after unilateral adrenalectomy for ACTH-independent hypercortisolism in a series of fifty patients. Journal of Endocrinological Investigation, 28, 327-332. (Pubitemid 43162751)
65. Fallo, F., Sonino, N., Barzon, L., et al. (1996) Effect of surgical treatment on hypertension in Cushing's syndrome. American Journal of Hypertension, 9, 77-80. (Pubitemid 26060112)