New aspects in diagnosis and treatment of Cushing´s disease.

LABEUR, M.; THEODOROPOULOU, M.; SIEVERS, C.; PAEZ-PEREDA, M.; CASTILLO, V.; ARZT, E.; STALLA, G. K.

Pituitary Today: Molecular, Physiological and Clinical Aspects

Karger Publishers; Editor-in-Chief Ashley B. Grossman, Eds Arzt Guitelman, Bronstein

Año: 2006; p. 169 - 178

Abstract Cushing’s disease which is caused by excessive production of ACTH is a rare and complex endocrine disorder that still represents a major challenge for the physician in terms of accurate diagnosis and efficient treatment. Diagnosing Cushing‘s syndrome and its etiology is an elaborate procedure and no single test is sensitive and specific enough to provide sufficient accuracy. Therefore an ordered cascade of tests is necessary recommended by a consensus statement in 2002. The proposed diagnostic algorithm will be summarized in the following section. In the absence of efficient drug therapy, transsphenoidal resection of the pituitary adenoma is the treatment of choice for the reduction of ACTH secretion. However, not all patients can be cured by surgery. In the present article we examine recent studies that have investigated the therapeutic potential of new generations of drugs for the treatment of Cushing´s disease such as cabergoline and SOM230. The role of nuclear receptors: retinoic acid receptors and peroxisome proliferator-activated receptor-g as new approaches for treating pituitary tumours is also discussed.