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MaryO

Early Detection, Treatment Needed To Reduce Risk Of Death, Cardiovascular Disease In Cushing's Disease Patients

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Even after successful treatment, patients with Cushing’s disease who were older when diagnosed or had prolonged exposure to excess cortisol face a greater risk of dying or developing cardiovascular disease, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

 

Cushing’s disease is a rare condition where the body is exposed to excess cortisol – a stress hormone produced in the adrenal gland – for long periods of time.

 

Researchers have long known that patients who have Cushing’s disease are at greater risk of developing and dying from cardiovascular disease than the average person. This study examined whether the risk could be eliminated or reduced when the disease is controlled. Researchers found that these risk factors remained long after patients were exposed to excess cortisol.

 

“The longer patients with Cushing’s disease are exposed to excess cortisol and the older they are when diagnosed, the more likely they are to experience these challenges,” said Eliza B. Geer, MD, of Mount Sinai Medical Center and lead author of the study. “The findings demonstrate just how critical it is for Cushing’s disease to be diagnosed and treated quickly. Patients also need long-term follow-up care to help them achieve good outcomes.”

 

The study found cured Cushing’s disease patients who had depression when they started to experience symptoms of the disease had an elevated risk of mortality and cardiovascular disease. Men were more at risk than women, a trend that may be explained by a lack of follow-up care, according to the study. In addition, patients who had both Cushing’s syndrome and diabetes were more likely to develop cardiovascular disease.

The study examined one of the largest cohorts of Cushing’s disease patients operated on by a single surgeon. The researchers retrospectively reviewed charts for 346 Cushing’s disease patients who were treated between 1980 and 2011. Researchers estimated the duration of exposure to excess cortisol by calculating how long symptoms lasted before the patient went into remission. The patients who were studied had an average exposure period of 40 months.

 

The findings may have implications for people who take steroid medications, Geer said. People treated with high doses of steroid medications such as prednisone, hydrocortisone or dexamethasone are exposed to high levels of cortisol and may experience similar conditions as Cushing’s disease patients.

 

“While steroid medications are useful for treating patients with a variety of conditions, the data suggests health care providers need to be aware that older patients or those who take steroid medications for long periods could be facing higher risk,” Geer said. “These patients should be monitored carefully while more study is done in this area.”

 

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You're most welcome.

 

It's not enough that we should worry about diagnosing and treating our Cushing's but this adds another level on to it :(

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Frustrating...Cushing's just keeps on giving and giving! :/ I have always believed that people who were sick a long time and severely had damage done that was permanent.

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That's fantastic, lmdtap. Could I add her to the Helpful Doctor list? If so, do you have her contact info?

 

Thanks

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Hi Mary,

 

I'm a bit reluctant because she was bashed on here by someone. We all have our opinions of doctors who we may not have felt listened, but to basically publicly bash them is wrong. She's always done right by me but I was already post op when I saw her. I'd be happy to pass her info on to anyone who sent a pm.

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I remember saying to one of my unhelpful docs that "if I have cushings I would like to skip the organ damage and more permanent side effects please". It didn't work because she was an idiot but I think most of us feel like we are trying to beat the clock on these type of outcomes. It's such a tedious drawn out process. Either way, more primary care and endos need to get it straight on how to at least triage and properly refer cushings patients on a more timely fashion. It's pretty crazy that in 2 years I got nowhere And in 1 month with a cushings specialist I was diagnosed And off to surgery!

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Wow. What is an "older" patient? I was 43 when my tumor was finally discovered. I had symptoms for 8 years before I was diagnosed and the adrenal tumor was removed. My doctors all seem to think that I am fine now that the tumor is gone--even though I feel sick and tired all the time. It's hard enough to get doctors to pay attention to Cushing's--I hope some attention will be focused on "post-Cushing's" syndrome. I'm starting to think they believe it is all in my head.

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