Diagnosis and therapeutic management of Cushing's Syndrome

Authors

  • Alexsandro Klingelfus Universidade Maurício de Nassau - Cacoal Author
  • Renata de Andrade Junqueira Universidade Maurício de Nassau - Cacoal Author
  • Misael de Holanda Macedo Universidade de Ceuma Author
  • Ana Paula Sousa Leite Universidade de Ceuma Author
  • Carlene Alves Feitosa Universidade Maurício de Nassau - Rondônia Author

DOI:

https://doi.org/10.5281/zenodo.14444064

Keywords:

Cushing's Syndrome, Diagnosis, Therapy, Surgical treatment, Drug treatment, Endocrine tumors

Abstract

Introduction: Cushing's syndrome (CS) is an endocrine disorder resulting from prolonged exposure to high levels of glucocorticoids, either through exogenous use or excessive endogenous production. Its manifestations vary, including metabolic, cardiovascular, and musculoskeletal complications, making early diagnosis difficult and increasing mortality. Objective: This article reviews recent advances in biochemical diagnosis, tumor localization, and therapeutic modalities for CS, as well as future perspectives for its management. Methodology: An exploratory and qualitative literature review was carried out in the PubMed, SciELO, LILACS, Google Scholar, and MEDLINE databases, considering publications between 2021 and 2023. After initial screening, six articles were analyzed according to the inclusion criteria that directly addressed the diagnosis or treatment of CS. Results and Discussion: Endogenous CS, more frequent in women, often results from ACTH-producing pituitary adenoma. Diagnosis involves confirming hypercortisolism, determining ACTH dependence, and localizing the lesion by imaging tests. Surgical treatment, usually transsphenoidal for pituitary adenomas or adrenalectomy for adrenal tumors, is the first choice. When this is not feasible, drug therapies (steroidogenesis inhibitors, cortisol receptor antagonists), radiotherapy or bilateral adrenalectomy are adopted. New treatments include targeted therapies and molecular imaging techniques, increasing diagnostic accuracy and therapeutic efficacy. Final Considerations: CS is a complex clinical challenge, requiring an individualized approach. Recent advances in diagnosis and therapy offer better control of hypercortisolism, minimizing complications. Continuous research and therapeutic innovations promise to improve the prognosis and quality of life of patients, making treatment safer, more effective and less invasive.

References

FLESERIU, Maria; LINDE, Tanja; FLIER, Jeffrey S. Update on Cushing’s syndrome: pathophysiology, diagnosis, and treatment. The Lancet Diabetes & Endocrinology, v. 9, n. 12, p. 847-865, 2021.

GARBEZZA, Giuseppe et al. Transsphenoidal Surgery for Cushing Disease: A Systematic Review and Meta-Analysis. Endocrine Practice, v. 25, n. 5, p. 463-472, 2019.

LACROIX, André; FEELING-TAYLOR, Amy; STRATAKIS, Constantine A. Cushing’s syndrome. The Lancet, v. 386, n. 9996, p. 913-927, 2015.

NEWMAN, Cara B.; LACROIX, André; SAHADEVAN, Jean-Paul. Advances in the diagnosis and treatment of Cushing’s syndrome. Endocrinology and Metabolism Clinics of North America, v. 49, n. 3, p. 367-383, 2020.

NIEMAN, Lynnette K. et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, v. 93, n. 5, p. 1526-1540, 2008.

NEWELL-PRICE, John et al. Cushing’s syndrome. The Lancet, v. 395, n. 10221, p. 913-927, 2020.

SROUGI, Vania et al. Endoscopic Endonasal Approach for Pituitary Adenomas Associated with Cushing’s Disease: Outcomes and Prognostic Factors. Journal of Neurosurgery, v. 135, n. 4, p. 1115-1124, 2021.

Published

2024-12-13

Issue

Section

Articles

How to Cite

KLINGELFUS, Alexsandro; JUNQUEIRA, Renata de Andrade; MACEDO, Misael de Holanda; LEITE, Ana Paula Sousa; FEITOSA, Carlene Alves. Diagnosis and therapeutic management of Cushing’s Syndrome. Journal of Social Issues and Health Sciences (JSIHS), [S. l.], v. 1, n. 7, 2024. DOI: 10.5281/zenodo.14444064. Disponível em: https://ojs.thesiseditora.com.br/index.php/jsihs/article/view/224.. Acesso em: 26 feb. 2025.