Successful treatment with sodium valproate of a patient with Cushing's disease and gross enlargement of the pituitary
| Autor: | Hans P. F. Koppeschaar, C. J. M. Arts, Jos H.H. Thijssen, R. J. M. Croughs, F. Schwarz, Hendriks Mj, J. W. van 't Verlaat |
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| Rok vydání: | 1984 |
| Předmět: |
Adenoma
Pituitary gland medicine.medical_specialty Hypophysectomy Hydrocortisone medicine.drug_class Endocrinology Diabetes and Metabolism medicine.medical_treatment Cushing syndrome Endocrinology Adrenocorticotropic Hormone Internal medicine medicine Humans Pituitary Neoplasms Cushing Syndrome 17-Hydroxycorticosteroids business.industry Valproic Acid Adrenalectomy General Medicine Cushing's disease Middle Aged medicine.disease medicine.anatomical_structure Anticonvulsant Corticosteroid Female business |
| Zdroj: | Acta Endocrinologica. 107:471-475 |
| ISSN: | 1479-683X 0804-4643 |
| DOI: | 10.1530/acta.0.1070471 |
| Popis: | Transfrontal hypophysectomy was performed in a patient with Cushing's disease and gross enlargement of the pituitary. Despite some reduction of cortisol production active Cushing's syndrome remained due to the presence of a tumour remnant. Medical treatment with the GABA-transaminase inhibitor sodium valproate induced hypocorticism necessitating corticosteroid substitution therapy. Nine months after sodium valproate withdrawal hypercorticism was documented. Re-institution of sodium valproate treatment induced hypocorticism again. As sodium valproate is known to induce a decrease of plasma ACTH in Nelson's syndrome, it is proposed that large tumours present at the time of diagnosis and those appearing after adrenalectomy may represent the spectrum of a single disorder. A prospective trial to study the effects of sodium valproate and other neurotransmitter modulating agents on the size and endocrine function of ACTH secreting macroadenomas is urgently needed. |
| Databáze: | OpenAIRE |
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