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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2017 Nov 03

DOI: 10.23736/S0391-1977.17.02771-7


language: English

Different therapeutic options in patients with Cushing's syndrome due to bilateral macronodular adrenal hyperplasia

Nora M. ALBIGER 1 , Daniela REGAZZO 1, Maurizio IACOBONE 2, Carla SCARONI 1

1 Endocrinology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy; 2 Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy


Bilateral macronodular adrenal hyperplasia (BMAH) is a relatively rare cause of Cushing’s syndrome (CS). In recent years, growing evidence has shown that steroidogenesis is regulated by aberrant G-protein-coupled receptors (GPCR) expression and their ligands, in a significant proportion of patients with BMAH. The screening of patients with overt or subclinical CS demonstrate the frequent expression of several GPCR that opened the option to potential therapeutic applications. Thus, several studies have demonstrated that targeting the involved receptor with specific antagonists, may result in a more or less effective control of cortisol excess. Bilateral adrenalectomy has traditionally been considered the treatment of choice for BMAH. However, unilateral adrenalectomy has been recently proposed as an alternative in selective patients to avoid the long-term necessity of gluco/mineralocorticoid replacement. Adrenal steroidogenesis inhibitors remains a valid option when medical treatment is needed due to high surgical risk.

KEY WORDS: Adrenal gland, Treatment Cushing's syndrome, BMAH

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Publication History

Article first published online: November 03, 2017
Manuscript accepted: October 30, 2017
Manuscript received: October 23, 2017

Cite this article as

Albiger NM, Regazzo D, Iacobone M, Scaroni C. Different therapeutic options in patients with Cushing's syndrome due to bilateral macronodular adrenal hyperplasia. Minerva Endocrinol 2017 Nov 03. DOI: 10.23736/S0391-1977.17.02771-7

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