Giperkortitsizm i metabolicheskiy sindrom: slozhnosti differentsial'noy diagnostiki i lecheniya

Cover Page


Hypercortisolism is a severe endocrine disorder that leads to all types of metabolic disturbances. The most frequent symptom of hypercortisolism is a specific weight gain and body fat distribution - "cushingoid" obesity which clinically reflects the pathological changes in protein, carbohydrate and lipids metabolism. We provide a clinical case of a patient with Cushing's disease. This clinical case represents challenges in the differential diagnosis of this rare endocrine disorder and metabolic syndrome, and specific approach in further evaluation and treatment of Cushing's disease that requires all the latest technology in this field to be employed.


  1. Белая ЖЕ, Ильин АВ, Мельниченко ГА, Рожинская ЛЯ, Драгунова НВ, Дзеранова ЛК, Огнева НА, Бутрова СА, Трошина ЕА, Колесникова ГС, Дедов ИИ. Автоматизированный электрохемилюминесцентный метод определения кортизола в слюне для диагностики эндогенного гиперкортицизма среди пациентов с ожирением. Ожирение и метаболизм 2011;27(2):56-63.
  2. Арапова СД, Белая ЖЕ, и др. Болезнь Иценко-Кушинга. Под ред. акад. РАН и РАМН И.И.Дедова, чл.-корр. РАМН Г.А. Мельниченко. М., 2011.
  3. Дзеранова ЛК, Парамонов ВМ, Рожинская ЛЯ, Плещева АВ, Манченко ОВ, Воронцов АВ, Колесникова ГС, Григорьев АЮ, Пигарова ЕА. Особенности жирового обмена при болезни Иценко-Кушинга. Ожирение и метаболизм 2010;1(22):58-62.
  4. Alexandraki KI, Grossman AB. Novel insights in the diagnosis of Cushing's syndrome. Neuroendocrinologe 1992;1:35-43 (2010).
  5. Atkinson AB, Kennedy A, Wiggam MI, McCance DR, Sheridan B. Long-term remission rates after pituitary surgery for Cushing's disease: the need for long-term surveillance. Clin Endocrinol (Oxf) 2005;63(5):549-559.
  6. Colao A, Pivonello R, Spiezia S, et al. Persistence of increased cardiovascular risk in patients with Cushing's disease after five years of successful cure. J Clin Endocrinol Metab 1999;84:2664-72.
  7. Dinneen S, Alzaid A, Miles J, Rizza R. Effects of the normal nocturnal rise in cortisol on carbohydrate and fat metabolism in IDDM. Am J Physiol 1995;268 (4Pt 1):E595-E603.
  8. Fraser R, Ingram MC, Anderson NH, Morrison C, Davies E, Connell JM. Cortisol effects on body mass, blood pressure, and cholesterol in the general population. Hypertension. 1999;33(6):1364-8.
  9. Hammer GD, Tyrrell JB, Lamborn KR, et al. Transsphenoidal microsurgery for Cushing's disease: initial outcome and long-term results. J Clin Endocrinol Metab 2004;89(12):6348-6357.
  10. Chowdhury IN, Sinaii N, Oldfield EH, Patronas N, Nieman LK. А change in pituitary MRI protocol detects ACTH-secreting tumours in patients with previously negative results. Clin Endocrinol (Oxf) 2010 April;72(4):502-506.
  11. McCane DR, Besser M, Atkinson AV. Assessment of cure after transsphenoidal surgery for Cushing's disease Clin. Endocrinol 1996;44-1:1-6.
  12. Peppa M, Krania M, Raptis SA. Hypertension and other morbidities with Cushing's syndrome associated with corticosteroids: a review. Integr Blood Press Control 2011;4:7-16.
  13. Steiner E, Imhof H, Knosp E. Gd-DTPA enhanced high resolution MR imaging of pituitary adenomas. Radiographics 1989;9:587-598.
  14. Tauchmanova L, Rossi R, Biondi B, Pulcrano M, Nuzzo V, Palmieri EA, Fazio S, Lombardi G. Patients with subclinical Cushing's syndrome due to adrenal adenoma have increased cardiovascular risk. J Clin Endocrinol Metab 2002;87 (11):4872-8.
  15. Trainer PJ, Lawrie HS, Verhelst J, Howlett TA, Lowe DG, Grossman AB, Savage MO, Afshar F, Besser GM. Transsphenoidal resection in Cushing's disease: undetectable serum cortisol as the definition of successful treatmen. Clin Endocrinol (Oxf) 1993;38:73-78.
  16. Mancini T, Porcelli T, Giustina A. Treatment of Cushing disease: overview and recent findings. Ther Clin Risk Manag 2010;6:505-516.
  17. Ross EJ, Linch DC. Cushing's syndrome-killing disease: discriminatory value of signs and symptoms aiding early diagnosis. Lancet 1982;2:646-649.



Abstract - 1205

PDF (Russian) - 6447



Copyright (c) 2012 Dzeranova L.K., Pankratova Y.V., Belaya Z.E., Pigarova E.A., Manchenko O.V., Rozhinskaya L.Y., Grigor'ev A.Y., Kolesnikova G.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies