Hypercortisolism Due to Paraganglioma Secreting Adrenocorticotropin and Catecholamines

JCEM Case Reports, Journal Year: 2025, Volume and Issue: 3(5)

Published: March 27, 2025

Abstract A paraganglioma is a neuroendocrine tumor classically associated with catecholamine production. We describe 71-year-old woman an incidentally identified para-aortic mass who later developed hyperglycemia, hypertension, hypokalemia, and leukocytosis. Work-up ultimately revealed significantly elevated adrenocorticotropin (ACTH), cortisol, metanephrines, biopsy of the suggested cosecretion both ACTH catecholamines. Using osilodrostat to decrease her excess cortisol production, she underwent successful surgical resection. Pathology demonstrated ACTH-producing cells, confirming diagnosis ectopic Cushing syndrome (CS). Following resection, patient had resolution hypertension hyperglycemia normalization hypothalamic-pituitary-adrenal axis. work-up important perioperative long-term management considerations for patients hypercortisolism from CS excess.

Language: Английский

Uso dell’osilodrostat: dagli studi LINC alla real world nelle sindromi di Cushing da ACTH ectopico

L Endocrinologo, Journal Year: 2025, Volume and Issue: unknown

Published: April 22, 2025

Osilodrostat treatment in patients with Cushing’s disease of Asian or non-Asian origin: a pooled analysis of two Phase III randomized trials (LINC 3 and LINC 4)

Endocrine Journal, Journal Year: 2024, Volume and Issue: 71(12), P. 1103 - 1123

Published: Jan. 1, 2024

Cushing's disease is associated with increased morbidity and mortality. Osilodrostat, a potent oral 11β-hydroxylase inhibitor, provided rapid, sustained mean urinary free cortisol (mUFC) normalization in patients two Phase III studies (LINC 3, NCT02180217; LINC 4, NCT02697734). Here, we evaluate the efficacy safety of osilodrostat Asian origin compared non-Asian origin. Pooled data from 3 4 were analyzed. Outcomes evaluated separately for patients. For analysis, 210 included; 56 (27%) Median (minimum-maximum) dose was 3.8 (1-25) 7.3 (1-47) mg/day patients, respectively. mUFC control achieved at weeks 48 72 64.3% 68.1% 68.2% 75.8% Improvements cardiovascular metabolic-related parameters, physical manifestations hypercortisolism, quality life similar both groups. Most common adverse events (AEs) adrenal insufficiency (44.6%) nausea (45.5%) AEs related to hypocortisolism pituitary tumor enlargement occurred more (58.9% 21.4%) than (40.3% 9.1%). Of 23.2% 13.6%, respectively, discontinued because AEs. generally required numerically lower doses achieve beneficial effects. Hypocortisolism-related reported Together, these findings suggest that are sensitive

Language: Английский