Neurosurgical Treatment of Nelson’s Syndrome

Total bilateral adrenalectomy remains the definitive procedure for cure in Cushing’s disease. It is complicated by the development of Nelson’s syndrome, the treatment of which remains troublesome. We report the long-term follow-up, median 17 yr (range, 8–22 yr), of 13 patients (3 males and 10 female...

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Published in:The journal of clinical endocrinology and metabolism 2002-12, Vol.87 (12), p.5465-5469
Main Authors: Kelly, P. A., Samandouras, G., Grossman, A. B., Afshar, F., Besser, G. M., Jenkins, P. J.
Format: Article
Language:English
Subjects:
Adrenocorticotropic Hormone - blood
Adult
Aged
Biological and medical sciences
Diabetes Insipidus - etiology
Female
Follow-Up Studies
Hormones - deficiency
Hormones. Endocrine system
Humans
Hypophysectomy - adverse effects
Male
Medical sciences
Middle Aged
Nelson Syndrome - surgery
Pharmacology. Drug treatments
Pituitary Gland, Anterior - metabolism
Time Factors
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Summary:Total bilateral adrenalectomy remains the definitive procedure for cure in Cushing’s disease. It is complicated by the development of Nelson’s syndrome, the treatment of which remains troublesome. We report the long-term follow-up, median 17 yr (range, 8–22 yr), of 13 patients (3 males and 10 females) treated with pituitary surgery for Nelson’s syndrome at a median age of 35 yr (range, 21–67 yr). The presence of a pituitary mass lesion necessitated neurosurgery in all. Preoperatively, the median plasma ACTH level was 664 pmol/liter (range, 92–3665 pmol/liter); this fell to 29 pmol/liter (range,
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2002-020299