Orvosi Hetilap
Volume/Issue:
Volume 148: Issue 5
Treatment of iatrogenic Cushing’s syndrome: questions of glucocorticoid withdrawal
Authors: Péter Igaz 1 , Károly >Rácz 1 , Miklós Tóth 1 , Edit Gláz 1 , and Zsolt Tulassay
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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088
  • 2 MTA-SE Gastroenterológiai és Endokrinológiai Kutatócsoport Budapest
DOI:
https://doi.org/10.1556/oh.2007.27964
Page Count:
195–202
Publication Date:
01 Feb 2007
Online Publication Date:
30 Jan 2007
Article Category:
Research Article
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A iatrogén Cushing-szindróma a hypercortisolismus leggyakoribb formája. Számos betegség kezelésében alkalmaznak sokszor nagy adagban glükokortikoidokat, ami nem ritkán súlyos klinikai képpel jellemzett hypercortisolismus kialakulásához vezet. A iatrogén Cushing-szindróma különlegességét az exogén glükokortikoidok okozta hypercortisolismus tüneteinek és az endogén hypothalamo-hypophysis-mellékvese rendszer gátlásának kettőssége adja. A kórkép kezelésének központi kérdése a glükokortikoid terápia leépítésének nehézsége. A hypothalamus-hypophysis-mellékvese rendszer gátlásában és regenerálódásában igen nagy fokú az egyének közötti variabilitás, emiatt a leépítés megtervezése csak fokozatosan, a klinikai kép és az endogén hormonaktivitás hatékonyságát jelző laboratóriumi paraméterek figyelembe vételével lehetséges. A leépítés során három fő szövődmény jelentkezhet: az alapbetegség reaktiválódása, másodlagos mellékvesekéreg-elégtelenség kialakulása, ill. az ún. szteroid megvonási tünetegyüttes. A szerzők saját klinikai tapasztalataik és a nemzetközi irodalom javaslatai alapján foglalják össze a témakör legfontosabb kérdéseit.

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Cover Orvosi Hetilap
Orvosi Hetilap
Print ISSN:
0030-6002
Online ISSN:
1788-6120
Keywords:
iatrogén; hypercortisolismus; glükokortikoid, leépítés; másodlagos mellékvesekéreg-elégtelenség; iatrogenic; hypercortisolism; glucocorticoid; withdrawal; secondary adrenal insufficiency

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