Cushing's Disease

An Often Misdiagnosed and Not So Rare Disorder

1st Edition - November 8, 2016

Editors: Edward R. Laws Jr, Louise Pace

Paperback ISBN:

9 7 8 - 0 - 1 2 - 8 0 4 3 4 0 - 0

eBook ISBN:

9 7 8 - 0 - 1 2 - 8 0 4 3 9 0 - 5

Cushing’s Disease: An Often Misdiagnosed and Not So Rare Disorder reviews the epidemiology of Cushing’s, including statistics on the incidence and prevalence of this disease.… Read more

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Cushing’s Disease: An Often Misdiagnosed and Not So Rare Disorder reviews the epidemiology of Cushing’s, including statistics on the incidence and prevalence of this disease. There are discussions of the signs and symptoms and the most common co-morbidities, such as diabetes mellitus, hypertension, osteoporosis, amenorrhea, and infertility.

Surgical, medical, and radiotherapeutic treatments, including indications, results, risks, and complications, are reviewed. Also featured is a chapter on the patient’s perspective, coping with Cushing’s, quality of life, and psychosomatic issues.

This book is essential reading for the wide range of physicians who treat patients with Cushing’s disease symptoms, as well as biomedical researchers who investigate the etiology and mechanisms of rare genetic diseases, in particular rare endocrine disorders.

Dedication
List of Contributors
Preface
List of Abbreviations
Introduction
Chapter 1: The Pituitary Gland: Anatomy, Physiology, and its Function as the Master Gland
- Abstract
- 1. Introduction
- 2. History
- 3. Embryology
- 4. Anatomy
- 5. Physiology
- 6. Homeostasis
- 7. Hypopituitarism
- 8. Conclusions
Chapter 2: Epidemiology and Etiology of Cushing’s Disease
- Abstract
- 1. Introduction
- 2. Epidemiology of Cushing’s Disease
- 3. Etiology of Cushing’s Disease
- 4. Conclusions
- Disclosures
Chapter 3: Physical Presentation of Cushing’s Syndrome: Typical and Atypical Presentations
- Abstract
- 1. Introduction
- 2. Symptoms of Cushing’s disease
- 3. Signs of Cushing’s disease
- 4. Comorbidities associated with Cushing’s syndrome
- 5. Cyclical Cushing’s syndrome
- 6. Cushing’s syndrome in athletes
- 7. Pseudo-Cushing’s disease
- 8. Cushing’s syndrome in children and adolescents
- 9. Conclusions
Chapter 4: The Cognitive, Psychological, and Emotional Presentation of Cushing’s Disease
- Abstract
- 1. Introduction
- 2. Cognitive and emotional aspects of Cushing’s disease
- 3. Effects of glucocorticoid excess on brain structures
- 4. Effects of glucocorticoid excess on brain metabolism
- 5. Reversibility of cognitive and psychological effects with treatment of Cushing’s disease
- 6. Conclusions
Chapter 5: Making the Diagnosis: Laboratory Testing and Imaging Studies
- Abstract
- 1. Making the diagnosis of Cushing’s syndrome
- 2. The differential diagnosis of Cushing’s syndrome
- 3. Prerequisites for differential diagnostic testing
Chapter 6: Surgical Treatment of Cushing’s Disease
- Abstract
- 1. Indications for surgery
- 2. Preoperative considerations
- 3. Operative considerations
- 4. Potential complications of surgery
- 5. Surgical techniques
- 6. Postoperative routines
- 7. Discharge and postdischarge care
- 8. Outcomes of surgery for Cushing’s disease
Chapter 7: Medical Treatment of Cushing’s Disease
- Abstract
- 1. Overview of medical therapy and its role in the management of Cushing’s Disease
- 2. Classification of medical therapies used in the treatment of Cushing’s disease
- 3. Special populations
- 4. Conclusions
Chapter 8: Multidisciplinary Management of Cushing’s Disease: Centers of Excellence Approach
- Abstract
- 1. Introduction
- 2. Brief history of COEs in medicine
- 3. Rationale for COE models in pituitary tumor management
- 4. Essential components of a team approach to Cushing’s disease
- 5. Team management of the Cushing’s disease patient over time
- 6. The role of pituitary COEs in advancing education and research in cushing’s disease
- 7. The future of pituitary Centers of Excellence and working with available expertise
Chapter 9: Posttreatment Management of Cushing’s Disease
- Abstract
- 1. Introduction
- 2. Definitions: cured, persistent, and recurrent Cushing’s disease
- 3. Management of persistent and recurrent Cushing’s disease
- 4. Posttreatment management of Cushing’s disease
- 5. Long-term effects of hypercortisolism in cured patients
Chapter 10: Coping with Cushing’s Disease: the Patients’ Perspectives
- Abstract
- 1. Introduction
- 2. Coping with a rare disease
- 3. Health complaints in the active phase
- 4. Diagnosis
- 5. Treatment
- 6. Recovery and long-term comorbidities
- 7. Conclusions
Chapter 11: Cushing’s Disease in Children and Adolescents: Diagnosis and Management
- Abstract
- 1. Introduction
- 2. Epidemiology
- 3. Etiology and pathogenesis
- 4. Clinical presentation
- 5. Diagnostic guidelines and confirmation of the diagnosis of cushing’s disease
- 6. Therapy
- 7. Conclusions
Chapter 12: Challenges and Future Developments for Improvement in the Diagnosis and Management of Cushing’s Disease
- Abstract
- 1. Imaging
- 2. Intraoperative techniques
- 3. Genetic factors and potential therapies
Appendix: Patients’ Perspectives
Index