Skip to main content
SpringerLink
Log in

Terapia della malattia di Cushing

  • Published:
L’Endocrinologo Aims and scope

Riassunto

La malattia di Cushing è una patologia che a tutt’oggi non dispone di un trattamento pienamente soddisfacente. Il primo approccio terapeutico, la rimozione dell’adenoma ipofisario secernente ACTH, si rivela risolutivo, infatti, nel 70% circa dei pazienti con un rischio di recidiva del 15%. Delle restanti opzioni terapeutiche, reintervento ipofisario, terapia radiante e surrenectomia bilaterale, solo quest’ultima dà garanzie di guarigione a spese, però, della necessità di una terapia sostitutiva ad vitam. La terapia farmacologica ha solamente una valenza di ripiego nei pazienti inoperabili o in attesa di efficacia della terapia radiante. Pur con queste limitazioni, è tuttavia possibile, attraverso un uso oculato delle diverse risorse terapeutiche, talvolta impiegate in successione e/o in concomitanza, portare alla guarigione la maggior parte dei pazienti.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Bibliografia

  1. Invitti C, Pecori Giraldi F, De Martin M, Cavagnini F, the Study Group of the Italian Society of Endocrinology on the Pathophysiology of the Hypothalamic-Pituitary-Adrenal Axis. Diagnosis and management of Cushing’s syndrome: results of an Italian multicentre study. J Clin Endocrinol Metab 84: 440, 1999.

    PubMed  CAS  Google Scholar 

  2. Lüdecke DK, Flitsch J, Knappe UJ, Saeger W. Cushing’s disease: a surgical view. J Neurooncol 54: 151, 2001.

    Article  PubMed  Google Scholar 

  3. Chee GH, Mathias DB, James RA, Kendall-Taylor P. Transsphenoidal pituitary surgery in Cushing’s disease: can we predict outcome? Clin Endocrinol 54: 617, 2001.

    Article  CAS  Google Scholar 

  4. Bochicchio D, Losa M, Buchfelder M, the European Cushing’s Disease Survey Group. Factors influencing the immediate and late outcome of Cushing’s disease treated by transsphenoidal surgery: a retrospective study by the European Cushing’s Disease Survey Group. J Clin Endocrinol Metab 80: 3114, 1995.

    PubMed  CAS  Google Scholar 

  5. Semple PL, Laws ER Jr. Complications in a contemporary series of patients who underwent transsphenoidal surgery for Cushing’s disease. J Neurosurg 91: 175, 1999.

    Article  PubMed  CAS  Google Scholar 

  6. Nagesser SK, van Seters AP, Kievit J, Hermans J, Kraus JMJ, van de Velde CJH. Long-term results of total adrenalectomy for Cushing’s disease. World J Surg 24: 108, 2000.

    Article  PubMed  CAS  Google Scholar 

  7. Grabner P, Hauer-Jensen M, Jervell J, Flatmark A. Long-term results of treatment of Cushing’s disease by adrenalectomy. Eur J Surg 157: 461, 1991.

    PubMed  CAS  Google Scholar 

  8. Estrada J, Boronat M, Mielgo M, Magallon R, Millan I, Diez S, Lucas T, Barcelo B. The long-term outcome of pituitary irradiation after unsuccessful transsphenoidal surgery in Cushing’s disease. N Engl J Med 336: 172, 1997.

    Article  PubMed  CAS  Google Scholar 

  9. Magiakou MA, Mastorakos G, Oldfield EH, Gomez MT, Doppman JL, Cutler GB Jr, Nieman LK, Chrousos GP. Cushing’s syndrome in children and adolescents. N Engl J Med 331: 629, 1994.

    Article  PubMed  CAS  Google Scholar 

  10. Sonino N. The use of ketoconazole as an inhibitor of steroid production. N Engl J Med 317: 812, 1987.

    Article  PubMed  CAS  Google Scholar 

  11. Kawai S, Ichikawa Y, Kaburaki J, Yoshida T. 18 years mitotane therapy for intractable Cushing’s disease. Lancet 354: 951, 1999.

    PubMed  CAS  Google Scholar 

  12. Verhelst JA, Trainer PJ, Howlett TA, Perry L, Rees LH, Grossman AB, Wass JAH, Besser GM. Short and long-term responses to metyrapone in the medical management of 91 patients with Cushing’s syndrome. Clin Endocrinol 35: 169, 1991.

    Article  CAS  Google Scholar 

  13. Chu JW, Matthias DF, Belanoff J, Schatzberg A, Hoffman AR, Feldman D. Successful long-term treatment of reafractory Cushing’s disease with high-dose mifepristone (RU 486). J Clin Endocrinol Metab 86: 3568, 2001.

    PubMed  CAS  Google Scholar 

  14. Mercado-Asis LB, Yasuda K, Murayama M, Mune T, Morita H, Kiura K. Beneficial effects of high daily dose bromocriptine treatment in Cushing’s disease. Endocrinol Japan 39: 385, 1992.

    Article  CAS  Google Scholar 

  15. Koppeschaar HPF, Croughs RJM, Thijssen JHH, Schwarz F. Response to neurotransmitter modulating drugs in patients with Cushing’s disease. Clin Endocrinol 25: 661, 1986.

    Article  CAS  Google Scholar 

  16. Krieger DT, Amorosa L, Linick F. Cyproheptadine-induced remission of Cushing’s disease. N Engl J Med 293: 893, 1975.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divisione di Endocrinologia, Ospedale San Luca IRCCS, Istituto Auxologico Italiano, Università di Milano, Via Spagnoletto 3, 20149, Milano, Italia

    Francesca Pecori Giraldi (Cattedra di Endocrinologia) & Francesco Cavagnini (Cattedra di Endocrinologia)

Authors
  1. Francesca Pecori Giraldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesco Cavagnini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesca Pecori Giraldi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giraldi, F.P., Cavagnini, F. Terapia della malattia di Cushing. L’Endocrinologo 3, 166–175 (2002). https://doi.org/10.1007/BF03344421

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344421

Search

Navigation