Pituitary ACTH Hypersecretion

A disease of the PITUITARY GLAND characterized by the excess amount of ADRENOCORTICOTROPIC HORMONE secreted. This leads to hypersecretion of cortisol (HYDROCORTISONE) by the ADRENAL GLANDS resulting in CUSHING SYNDROME.

Also Known As:

Adrenocorticotropic Hormone, Inappropriate Secretion; Cushing Disease, Pituitary; Pituitary Cushing Syndrome; Pituitary-Dependant Cushing Syndrome; Pituitary-Dependant Hypercortisolism; Pituitary-Dependant Hypercortisolism Disorder; Cushing Syndrome, Pituitary; Cushing Syndrome, Pituitary-Dependant; Disease, Cushing; Hypercortisolism Disorder, Pituitary-Dependant; Hypercortisolism, Pituitary-Dependant; Hypersecretion, Pituitary ACTH; Pituitary Cushing Disease; Pituitary Dependant Cushing Syndrome; Pituitary Dependant Hypercortisolism; Pituitary Dependant Hypercortisolism Disorder; Pituitary-Dependant Hypercortisolism Disorders; Pituitary-Dependant Hypercortisolisms; Cushing Disease; Cushing's Disease; Inappropriate ACTH Secretion Syndrome; Inappropriate Adrenocorticotropic Hormone Secretion

Networked: 3191 relevant articles (318 outcomes, 288 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Cushing Syndrome
2.	Adenoma (Adenomas)
3.	Neoplasms (Cancer)
4.	Pituitary Neoplasms (Pituitary Adenoma)
5.	Acromegaly

Experts

1.	Fleseriu, Maria: 40 articles (05/2024 - 01/2007)
2.	Pivonello, Rosario: 34 articles (01/2023 - 03/2003)
3.	Stratakis, Constantine A: 30 articles (01/2024 - 09/2005)
4.	Reincke, Martin: 29 articles (12/2023 - 08/2014)
5.	Biller, Beverly M K: 29 articles (01/2023 - 08/2004)
6.	Laws, Edward R: 24 articles (11/2023 - 11/2002)
7.	Boscaro, Marco: 22 articles (01/2023 - 12/2004)
8.	Lacroix, André: 22 articles (01/2023 - 01/2002)
9.	Vance, Mary Lee: 21 articles (11/2023 - 11/2002)
10.	Kageyama, Kazunori: 20 articles (01/2023 - 12/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pituitary ACTH Hypersecretion:

1.	Hydrocortisone (Cortisol)FDA LinkGeneric 01/01/2022 - "The objectives of the study were to determine remission and recurrence rates after TSS for Cushing's disease, identify factors that predict these outcomes, and define the threshold for postoperative morning serum cortisol (MSeC) that most accurately predicts sustained remission. " 04/01/2012 - "Subnormal postoperative serum cortisol levels indicate successful surgery and predict long-term remission of Cushing disease. " 02/01/2011 - "During these years, there was a significant improvement in initial post surgery urinary cortisol levels in Cushing's disease as a function of surgical experience." 01/01/2022 - "Low but not undetectable early postoperative nadir serum cortisol predicts sustained remission in Cushing's disease." 01/01/1994 - "Patients were followed for 4 to 84 months (mean +/- standard deviation, 34 +/- 25 months) to document sustained remission or recurrence of Cushing's disease (a urine free cortisol level > 90 micrograms/day was considered evidence of recurrence). "
2.	Adrenocorticotropic Hormone (ACTH)FDA Link 05/01/2012 - "Bilateral inferior petrosal sinus sampling, the gold standard assay in diagnosing pituitary secretion of adrenocorticotropic hormone in Cushing disease, is highly accurate and safe when performed by experienced interventionalists. " 01/01/2005 - "Postoperatively, her serum ACTH concentration dropped below 5 pg/ml. In this case, inferior petrosal sinus sampling was extremely helpful for the diagnosis of Cushing disease, and operations were able to be performed safely using the neuronavigation system in drilling of the incompletely pneumatized sphenoid sinus." 10/01/2018 - "The present study evaluates the usefulness of an ACTH suppression test shortly after surgery, and to determine optimal cut-off values of included laboratory analyses, in predicting short- and long-term remission after surgery of Cushing's disease. " 06/01/2009 - "Outcome of transsphenoidal surgery for Cushing's disease: a high remission rate in ACTH-secreting macroadenomas." 09/01/1993 - "The CS/peripheral (CS/P) ratio of ACTH (mean = 66.1) was significantly greater than the IPS/peripheral (IPS/P) ratio (mean = 14.9) in Cushing disease. "
3.	pasireotideIBA 10/01/2019 - "Long-term safety and efficacy of subcutaneous pasireotide in patients with Cushing's disease: interim results from a long-term real-world evidence study." 01/01/2019 - "Safety and Efficacy of Subcutaneous Pasireotide in Patients With Cushing's Disease: Results From an Open-Label, Multicenter, Single-Arm, Multinational, Expanded-Access Study." 06/01/2015 - "Up-to 5-year efficacy of pasireotide in a patient with Cushing's disease and pre-existing diabetes: literature review and clinical practice considerations." 12/01/2014 - "A recent phase III randomized controlled trial (NCT00434148) showed efficacy of pasireotide in the treatment of patients with Cushing's disease (CD). " 11/01/2020 - "Long-acting pasireotide improves clinical signs and quality of life in Cushing's disease: results from a phase III study."
4.	Cyproheptadine (Periactin)FDA Link 08/01/1981 - "A patient with Cushing's disease was treated with cyproheptadine with concomitant remission of the disease for 60 months. " 10/30/1975 - "Cyproheptadine-induced remission of Cushing's disease." 03/01/1983 - "The experimental studies made it possible to successfully apply peritol to the treatment of inpatients suffering from Icenko-Cushing's disease. " 04/01/1996 - "Cyproheptadine treatment in Cushing's disease." 03/01/1989 - "These observations are the first to provide evidence supporting a pituitary effect of cyproheptadine in Cushing's disease in vivo and raise questions regarding the assumption of hypothalamic dysfunction in those patients with Cushing's disease responding to cyproheptadine."
5.	Growth Hormone (Somatotropin)IBA 08/01/2011 - "Surprisingly, growth hormone replacement resulted in complete clinical and laboratory remission of Cushing's disease in these patients. " 01/01/1998 - "This study demonstrates that in patients with Cushing's disease the somatotroph hyporesponsiveness to growth hormone releasing home is improved after a short-term hypocaloric diet. " 08/01/2011 - "Remission of Cushing's disease with growth hormone replacement." 02/01/2024 - "Cushing Disease (CD) is a rare endocrine disorder associated with impaired growth hormone (GH) and short stature. " 01/01/2021 - "Growth hormone deficiency in adults with Cushing's disease."
6.	Cabergoline FDA LinkGeneric 07/01/2016 - "This case report demonstrates that cabergoline may be an effective and safe therapeutic option for the treatment of Cushing's disease during pregnancy." 03/01/2017 - "The efficacy of cabergoline in Cushing's disease (CD) is controversial. " 09/10/2013 - "Remission with cabergoline in adolescent boys with Cushing's disease." 05/01/2008 - "Remission in Cushing disease with cabergoline." 11/01/2012 - "In conclusion, we suggest that all patients with Cushing's disease should undergo a therapeutic trial of cabergoline. "
7.	Bromocriptine (Parlodel)FDA LinkGeneric 03/01/1996 - "It has been reported that bromocriptine treatment for cyclic Cushing's disease induces only a transient remission; in the most effective cases, a relatively high dose (40 mg/day) was necessary. " 03/01/1996 - "A 56-year-old male patient with cyclic Cushing's disease remained in a state of remission for more than one year with a relatively low dose of bromocriptine (2.5-3.75 mg/day). " 01/01/2007 - "Bromocriptine-responsive Cushing's disease; clinical and biochemical remission accompanied by amelioration of impaired ocular movement." 03/01/1996 - "Cyclic Cushing's disease in long-term remission with a daily low dose of bromocriptine." 06/01/1978 - "[Clinical and biochemical remission of Itsenko-Cushing disease during parlodel treatment]."
8.	Dexamethasone (Maxidex)FDA LinkGeneric 01/01/2023 - "Of interest, blood from patients with Cushing disease in remission maintained high numbers of CD163+ monocytes and, although their CD34+ cells had a normal phenotype, these cells were unresponsive to added dexamethasone. " 11/01/1988 - "Stages of body responses to small doses of dexamethasone (the stage of lost responses, the stage of incomplete loss and the stage of recovered responses) were identified contributing to objective assessment of the gravity, course, presence, recurrence and remission of Itsenko-Cushing disease." 10/01/1976 - "Periodic remission in Cushing's disease with paradoxical dexamethasone response: an expression of periodic hormonogenesis." 01/01/2020 - "The purpose of the study is to evaluate the positive predictive value of the combined pituitary dynamic enhanced MRI (dMRI) and high-dose dexamethasone suppression tests (HDDST) in the diagnosis of Cushing's disease (CD) bypassing bilateral inferior petrosal sinus sampling (BIPSS). " 01/01/2013 - "In current study, we investigated whether OSAS affect the screening test for subclinical Cushing's disease using 0.5 mg overnight dexamethasone suppression test (DST) in Japanese obese diabetic patients with OSAS. "
9.	Hormones (Hormone)IBA 06/01/2005 - "Endocrinological remission occurred in 57% of patients undergoing RTSS to treat hormone hypersecretion; most of these patients had Cushing disease. " 09/01/2015 - "Bilateral inferior petrosal sinus sampling (BIPSS) following corticotropic-releasing hormone (CRH) stimulation is the current gold standard technique in the diagnosis of Cushing disease. " 03/08/2022 - "Cushing disease due to a somatic USP8 mutation in a patient with evolving pituitary hormone deficiencies due to a germline GH1 splicing variant." 01/01/2016 - "Moreover, some hormone-associated regions were found in the frontal and occipital cortex, possibly mediating the cognitive changes seen in Cushing's disease. " 02/01/2009 - "Comparisons between macroadenomas and microadenomas in Cushing's disease: characteristics of hormone secretion and clinical outcomes."
10.	Corticotropin-Releasing HormoneIBA 09/01/1995 - "The use of the corticotropin-releasing factor (CRF) stimulation test may be especially helpful in distinguishing Cushing's disease (CD) from major depression, though there is some degree of "overlap" in results. " 07/01/1989 - "The ovine corticotropin-releasing hormone (CRH) stimulation test is superior to the human CRH stimulation test for the diagnosis of Cushing's disease." 10/01/2022 - "The current gold standard diagnostic method for Cushing disease (CD) is bilateral inferior petrosal sinus sampling (BIPSS) after corticotropin-releasing hormone (CRH) stimulation. " 01/01/2018 - "Bilateral inferior petrosal sinus sampling (IPSS) with corticotropin-releasing hormone (CRH) is currently the gold standard in the diagnosis of Cushing's disease (CD) and has also been used in tumour lateralization. " 09/01/2013 - "Corticotropin-releasing hormone (CRH) loading test ruled out Cushing's disease and supported the diagnosis of EAS. "

Therapies and Procedures

1.	Therapeutics 12/01/2002 - "Gamma knife radiosurgery is safe and effective for the treatment of Cushing disease as an adjuvant or initial therapy when selective and accurate dose planning is performed." 02/01/2007 - "Studies on the clinical impact of GH deficiency and the use of GH replacement therapy seem warranted in patients cured from Cushing's disease." 04/01/2015 - "Transsphenoidal surgery remains the first line therapy in Cushing's disease, but a large number of patients will not be cured or disease will recur over time. " 07/01/2014 - "The LC-MS/MS was used to analyze UFF and UFE levels in 43 surgically confirmed CS patients: 26 with Cushing's disease (CD, 16 de novo and ten recurrences), 11 with adrenal CS and six with ectopic CS; 22 CD patients in remission; 14 eu-cortisolemic CD patients receiving medical therapy; 60 non-CS patients; and 70 healthy controls. " 04/01/2012 - "The hypercoagulable state in Cushing's disease is associated with increased levels of procoagulant factors and impaired fibrinolysis, but is not reversible after short-term biochemical remission induced by medical therapy."
2.	Adrenalectomy 04/01/1979 - "A complete remission of the signs, symptoms, and laboratory abnormalities of Cushing's disease occurred in all 18 patients following bilateral adrenalectomy. " 05/01/2007 - "Laparoscopic bilateral adrenalectomy for symptomatic Cushing's disease is a safe and effective treatment option. " 06/01/2021 - "The treatment of Cushing's disease (CD) has been advanced well with the introduction of treatment options like transsphenoidal surgery, radiosurgery, bilateral adrenalectomy, and various classes of medication; however, many patients still fail to achieve disease remission. " 05/01/2008 - "Improved quality of life after bilateral laparoscopic adrenalectomy for Cushing's disease." 05/01/2007 - "Improved quality of life after bilateral laparoscopic adrenalectomy for Cushing's disease: a 10-year experience."
3.	Radiotherapy 05/01/2011 - "Remission after radiation therapy occurs in ∼85% of patients with Cushing disease after a considerable latency period. " 09/01/2008 - "Assessment of GH secretion is therefore recommended in all patients cured from Cushing's disease, even if not submitted to radiotherapy." 02/01/2007 - "Assessment of GH secretion is therefore recommended for all patients cured from Cushing's disease, even if not submitted to radiotherapy. " 01/01/2010 - "Radiotherapy is an effective second-line treatment in patients with Cushing's disease not cured by surgery. " 11/01/2007 - "On the basis of the available literature, fractionated conventional and stereotactic radiotherapy offer effective treatment for Cushing's disease not controlled with surgery alone. "
4.	Aftercare (After-Treatment) 11/01/2019 - "Most patients had Cushing disease and were in remission after treatment. " 04/01/2004 - "Fifty-seven patients (42 female), in remission after treatment for Cushing's disease, were studied. " 09/01/2000 - "Growth and final height were analyzed in 10 patients who were cured or in remission after treatment of Cushing's disease. " 07/01/2024 - "Several studies have shown bone mass recovery in patients with Cushing's disease (CD) after treatment. " 06/01/2022 - "Increased Mortality Persists after Treatment of Cushing's Disease: A Matched Nationwide Cohort Study."
5.	Pituitary Irradiation 09/15/1984 - "It is therefore recommended that low dose external pituitary irradiation be used as definitive first line treatment for Cushing's disease." 01/16/1997 - "Pituitary irradiation is an effective and well-tolerated treatment for patients with Cushing's disease in whom transsphenoidal surgery is unsuccessful." 10/01/1989 - "To determine the efficacy of transsphenoidal surgery in recurrent or persistent Cushing's disease, we performed transsphenoidal surgery in 31 patients (22 women and nine men) who had previously undergone a transsphenoidal operation and two female patients who had had previous pituitary irradiation only. " 03/01/2009 - "We also review the different techniques that can be used for pituitary irradiation, as well as the efficacy and morbidity reported for each of these techniques in patients with Cushing's disease." 01/01/2009 - "Thirty-nine patients with either de novo Cushing's disease who were candidates for pituitary surgery or with persistent or recurrent Cushing's disease after surgery without having received prior pituitary irradiation. "