Metyrapone for Long-Term Medical Management of Cushing’s Syndrome

Cushing’s syndrome is characterized by any cause of excess cortisol in the blood and produces many physiologic consequences. Left untreated, Cushing’s is associated with significant morbidity and mortality. Seventy percent of endogenous cases of Cushing’s syndrome are secondary to a pituitary tumor;...

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Main Authors: Andrea N. Traina, Ashley Farr, Ritu Malik, Robert J. Bingham
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2013/782068
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author Andrea N. Traina
Ashley Farr
Ritu Malik
Robert J. Bingham
author_facet Andrea N. Traina
Ashley Farr
Ritu Malik
Robert J. Bingham
author_sort Andrea N. Traina
collection DOAJ
description Cushing’s syndrome is characterized by any cause of excess cortisol in the blood and produces many physiologic consequences. Left untreated, Cushing’s is associated with significant morbidity and mortality. Seventy percent of endogenous cases of Cushing’s syndrome are secondary to a pituitary tumor; because of this, the primary mode of management is surgical resection of the tumor. Should hypercortisolism persist following surgical resection, further treatment options are limited. Metyrapone is an orphan medication that is often used in the diagnosis of the disease and occasionally for short-term treatment prior to surgery. Long-term treatment with metyrapone is usually discouraged due to the contradictory increase in ACTH production, acne, hirsutism, hyperkalemia, edema, and other mineralocorticoid effects. We present a patient with refractory Cushing’s syndrome successfully treated for nearly 6 years with metyrapone with minimal adverse effects. This orphan medication may be a viable long-term treatment option for this difficult disease.
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spelling doaj-art-dfe8956a4f3c4f12b098c122a66e1df42025-02-03T07:24:21ZengWileyCase Reports in Endocrinology2090-65012090-651X2013-01-01201310.1155/2013/782068782068Metyrapone for Long-Term Medical Management of Cushing’s SyndromeAndrea N. Traina0Ashley Farr1Ritu Malik2Robert J. Bingham3AstraZeneca LP, 1800 Concord Pike, Wilmington, DE 19803, USASt. John Fisher College’s Wegmans School of Pharmacy, 3690 East Avenue, Rochester, NY 14618, USAEndocrine-Diabetes Care and Resource Center, Rochester General Health System, 224 Alexander Park, Suite 200, Rochester, NY 4607, USASchool of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USACushing’s syndrome is characterized by any cause of excess cortisol in the blood and produces many physiologic consequences. Left untreated, Cushing’s is associated with significant morbidity and mortality. Seventy percent of endogenous cases of Cushing’s syndrome are secondary to a pituitary tumor; because of this, the primary mode of management is surgical resection of the tumor. Should hypercortisolism persist following surgical resection, further treatment options are limited. Metyrapone is an orphan medication that is often used in the diagnosis of the disease and occasionally for short-term treatment prior to surgery. Long-term treatment with metyrapone is usually discouraged due to the contradictory increase in ACTH production, acne, hirsutism, hyperkalemia, edema, and other mineralocorticoid effects. We present a patient with refractory Cushing’s syndrome successfully treated for nearly 6 years with metyrapone with minimal adverse effects. This orphan medication may be a viable long-term treatment option for this difficult disease.http://dx.doi.org/10.1155/2013/782068
spellingShingle Andrea N. Traina
Ashley Farr
Ritu Malik
Robert J. Bingham
Metyrapone for Long-Term Medical Management of Cushing’s Syndrome
Case Reports in Endocrinology
title Metyrapone for Long-Term Medical Management of Cushing’s Syndrome
title_full Metyrapone for Long-Term Medical Management of Cushing’s Syndrome
title_fullStr Metyrapone for Long-Term Medical Management of Cushing’s Syndrome
title_full_unstemmed Metyrapone for Long-Term Medical Management of Cushing’s Syndrome
title_short Metyrapone for Long-Term Medical Management of Cushing’s Syndrome
title_sort metyrapone for long term medical management of cushing s syndrome
url http://dx.doi.org/10.1155/2013/782068
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