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Autonome Kortisolsekretion : Laborartefakt oder Krankheit?


Riester, Anna; Beuschlein, Felix (2022). Autonome Kortisolsekretion : Laborartefakt oder Krankheit? Der Internist, 63(1):18-24.

Abstract

Background: Autonomous cortisol secretion was mentioned for the first time in 2016 in the European Guideline on the management of adrenal incidentalomas.

Objectives: Review of the state of knowledge on diagnosis, epidemiology, co-morbidities, mortality and treatment of autonomous cortisol secretion in comparison to non-hormone producing adenomas. Recommendation for clinical practice based on the current European guideline.

Materials und methods: Analysis of relevant clinical studies, discussion of basic literature and expert opinions.

Results and conclusions: Autonomous cortisol secretion is a term used to describe abnormal cortisol secretion diagnosed by a pathological 1‑mg dexamethasone suppression test in patients with adrenal incidentaloma, but without clinical manifestation of overt Cushing's syndrome. It is associated with increased mortality and morbidity, especially hypertension, diabetes mellitus type II, dyslipidemia and obesity. Adrenalectomy, as the only specific therapy option, should be considered in an interdisciplinary tumour board.

Keywords: Adrenal adenoma; Adrenal incidentaloma; Cushing syndrome; Dexamethasone suppression test; Hypercortisolism.

Abstract

Background: Autonomous cortisol secretion was mentioned for the first time in 2016 in the European Guideline on the management of adrenal incidentalomas.

Objectives: Review of the state of knowledge on diagnosis, epidemiology, co-morbidities, mortality and treatment of autonomous cortisol secretion in comparison to non-hormone producing adenomas. Recommendation for clinical practice based on the current European guideline.

Materials und methods: Analysis of relevant clinical studies, discussion of basic literature and expert opinions.

Results and conclusions: Autonomous cortisol secretion is a term used to describe abnormal cortisol secretion diagnosed by a pathological 1‑mg dexamethasone suppression test in patients with adrenal incidentaloma, but without clinical manifestation of overt Cushing's syndrome. It is associated with increased mortality and morbidity, especially hypertension, diabetes mellitus type II, dyslipidemia and obesity. Adrenalectomy, as the only specific therapy option, should be considered in an interdisciplinary tumour board.

Keywords: Adrenal adenoma; Adrenal incidentaloma; Cushing syndrome; Dexamethasone suppression test; Hypercortisolism.

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Additional indexing

Other titles:Autonomous cortisol secretion : Laboratory artifact or disease?
Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Endocrinology and Diabetology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Internal Medicine
Uncontrolled Keywords:Internal Medicine
Language:German
Date:1 January 2022
Deposited On:07 Feb 2022 06:10
Last Modified:28 Nov 2023 02:37
Publisher:Springer
ISSN:0020-9554
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s00108-021-01188-6
PubMed ID:34709420
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