Cushing’s disease epidemiology and demographics: Difference between revisions
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'''Cushing's disease''' (also known as '''Cushing disease''', '''tertiary or secondary hypercortisolism''', '''tertiary or secondary hypercorticism''', '''Itsenko-Cushing disease''')<ref>[http://www.whonamedit.com/doctor.cfm/1520.html "Whonamedit - Nikolai Mikhailovich Itsenko"]. "Nikolai Mikhailovich Itsenko investigated neural infections, vegetative nervous system diseases and cerebral tumors. In 1926 he was the first one who described Itsenko-Cushing's disease, six years before Cushing."</ref><ref name="gozhenko">{{cite book|author=A.I. Gozhenko, I.P. Gurkalova, W. Zukow, Z. Kwasnik, B. Mroczkowska |title =Pathology: Medical Student's Library|chapter =Trematoda|publisher =Radomska Szkola Wyžsza uk. Zubrzyckiego|year =2009|page=280|isbn =978-83-61047-18-6|url =http://books.google.com.ph/books?id=Pvk0MoLNjgYC&lpg=PA280&dq=Itsenko-Cushing's%20disease%20and%20Itsenko-Cushing's%20syndrome%5C&pg=PA280#v=onepage&q=Itsenko-Cushing's%20disease%20and%20Itsenko-Cushing's%20syndrome%5C&f=false}}</ref> is a cause of [[Cushing's syndrome]] characterised by increased secretion of [[adrenocorticotropic hormone]] (ACTH) from the [[anterior pituitary]] ('''secondary''' [[hypercortisolism]]). This is most often as a result of a pituitary [[adenoma]] (specifically pituitary basophilism) or due to excess production of hypothalamus CRH ([[Corticotropin releasing hormone]]) ('''tertiary''' hypercortisolism/hypercorticism) that stimulates the synthesis of cortisol by the adrenal glands. Pituitary adenomas are responsible for 80% of endogenous Cushing's syndrome,<ref name="cushing's">{{cite journal|last=Lanzino|first=Giuseppe|author2=Maartens, Niki F. |author3=Laws, Edward R. |title=Cushing's case XLV: Minnie G.|journal=Journal of Neurosurgery|year=2002|volume=97|issue=1|pages=231–234|accessdate=January 30, 2014|pmid=12134925|doi=10.3171/jns.2002.97.1.0231}}</ref> when excluding Cushing's syndrome from exogenously administered [[corticosteroid]]s. | '''Cushing's disease''' (also known as '''Cushing disease''', '''tertiary or secondary hypercortisolism''', '''tertiary or secondary hypercorticism''', '''Itsenko-Cushing disease''')<ref>[http://www.whonamedit.com/doctor.cfm/1520.html "Whonamedit - Nikolai Mikhailovich Itsenko"]. "Nikolai Mikhailovich Itsenko investigated neural infections, vegetative nervous system diseases and cerebral tumors. In 1926 he was the first one who described Itsenko-Cushing's disease, six years before Cushing."</ref><ref name="gozhenko">{{cite book|author=A.I. Gozhenko, I.P. Gurkalova, W. Zukow, Z. Kwasnik, B. Mroczkowska |title =Pathology: Medical Student's Library|chapter =Trematoda|publisher =Radomska Szkola Wyžsza uk. Zubrzyckiego|year =2009|page=280|isbn =978-83-61047-18-6|url =http://books.google.com.ph/books?id=Pvk0MoLNjgYC&lpg=PA280&dq=Itsenko-Cushing's%20disease%20and%20Itsenko-Cushing's%20syndrome%5C&pg=PA280#v=onepage&q=Itsenko-Cushing's%20disease%20and%20Itsenko-Cushing's%20syndrome%5C&f=false}}</ref> is a cause of [[Cushing's syndrome]] characterised by increased secretion of [[adrenocorticotropic hormone]] (ACTH) from the [[anterior pituitary]] ('''secondary''' [[hypercortisolism]]). This is most often as a result of a pituitary [[adenoma]] (specifically pituitary basophilism) or due to excess production of hypothalamus CRH ([[Corticotropin releasing hormone]]) ('''tertiary''' hypercortisolism/hypercorticism) that stimulates the synthesis of cortisol by the adrenal glands. Pituitary adenomas are responsible for 80% of endogenous Cushing's syndrome,<ref name="cushing's">{{cite journal|last=Lanzino|first=Giuseppe|author2=Maartens, Niki F. |author3=Laws, Edward R. |title=Cushing's case XLV: Minnie G.|journal=Journal of Neurosurgery|year=2002|volume=97|issue=1|pages=231–234|accessdate=January 30, 2014|pmid=12134925|doi=10.3171/jns.2002.97.1.0231}}</ref> when excluding Cushing's syndrome from exogenously administered [[corticosteroid]]s. | ||
This should not be confused with [[Cushing's syndrome#Pathophysiology|ectopic Cushing syndrome]] or exogenous steroid use.<ref>http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001443/</ref> | This should not be confused with [[Cushing's syndrome#Pathophysiology|ectopic Cushing syndrome]] or exogenous steroid use.<ref>http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001443/</ref> | ||
==Epidemiology== | ==Epidemiology== | ||
Cases of Cushing's disease are rare, and few epidemiological data is available on the disease. An 18 year study conducted on the population of Vizcaya, Spain reported a 0.004% [[prevalence]] of Cushing's disease.<ref name=Epidemiology>{{cite journal|last=Etxabe|first=J.|author2=J. A. Vazquez|title=Morbidity and mortality in Cushing’s disease: an epidemiological approach|journal=Clinical endocrinology|year=1994|volume=40|issue=4|pages=479–484|accessdate=January 31, 2014|pmid=8187313|doi=10.1111/j.1365-2265.1994.tb02486.x}}</ref> The average [[incidence (epidemiology)|incidence]] of newly diagnosed cases was 2.4 cases per million inhabitants per year. The disease is often diagnosed 3–6 years after the onset of illness.<ref name=Epidemiology /> | Cases of Cushing's disease are rare, and few epidemiological data is available on the disease. An 18 year study conducted on the population of Vizcaya, Spain reported a 0.004% [[prevalence]] of Cushing's disease.<ref name=Epidemiology>{{cite journal|last=Etxabe|first=J.|author2=J. A. Vazquez|title=Morbidity and mortality in Cushing’s disease: an epidemiological approach|journal=Clinical endocrinology|year=1994|volume=40|issue=4|pages=479–484|accessdate=January 31, 2014|pmid=8187313|doi=10.1111/j.1365-2265.1994.tb02486.x}}</ref> The average [[incidence (epidemiology)|incidence]] of newly diagnosed cases was 2.4 cases per million inhabitants per year. The disease is often diagnosed 3–6 years after the onset of illness.<ref name=Epidemiology /> | ||
Several studies have shown that Cushing's disease is more prevalent in women than men at a ratio of 3-6:1, respectively.<ref>{{cite journal|last=Boggan|first=J.E |author2=Tyrell, J.B |author3=Wilson C.B|title=Transsphenoidal microsurgical management of Cushing’s disease: report of 100 cases.|journal=Journal of neurosurgery|year=1983|volume=95|issue=2|pages=195–200|url=http://thejns.org/doi/abs/10.3171/jns.1983.59.2.0195|doi=10.3171/jns.1983.59.2.0195}}</ref><ref>{{cite journal|last=Howlet|first=T.A|author2=Perry L. |author3=Doniach I. |author4=Rees LH. |author5=Besser G.M |title=Diagnosis and management of ACTHdependent Cushing’s syndrome: comparison of the features in ectopic and pituitary ACTH production.|journal=Clinical endocrinology|year=1986|volume=24|issue=6|pages=699–713|pmid=3024870|url=http://www.ncbi.nlm.nih.gov/pubmed/3024870|accessdate=January 31, 2014 |doi=10.1111/j.1365-2265.1986.tb01667.x}}</ref> Moreover, most women affected were between the ages of 50 and 60 years. | Several studies have shown that Cushing's disease is more prevalent in women than men at a ratio of 3-6:1, respectively.<ref>{{cite journal|last=Boggan|first=J.E |author2=Tyrell, J.B |author3=Wilson C.B|title=Transsphenoidal microsurgical management of Cushing’s disease: report of 100 cases.|journal=Journal of neurosurgery|year=1983|volume=95|issue=2|pages=195–200|url=http://thejns.org/doi/abs/10.3171/jns.1983.59.2.0195|doi=10.3171/jns.1983.59.2.0195}}</ref><ref>{{cite journal|last=Howlet|first=T.A|author2=Perry L. |author3=Doniach I. |author4=Rees LH. |author5=Besser G.M |title=Diagnosis and management of ACTHdependent Cushing’s syndrome: comparison of the features in ectopic and pituitary ACTH production.|journal=Clinical endocrinology|year=1986|volume=24|issue=6|pages=699–713|pmid=3024870|url=http://www.ncbi.nlm.nih.gov/pubmed/3024870|accessdate=January 31, 2014 |doi=10.1111/j.1365-2265.1986.tb01667.x}}</ref> Moreover, most women affected were between the ages of 50 and 60 years. | ||
The prevalence of [[hypertension]], and abnormalities in [[glucose metabolism]] are major predictors of [[Case fatality rate|mortality]] and [[morbidity]] in untreated cases of the disease.<ref name=Epidemiology /> The mortality rate of Cushing's disease was reported to be 10-11%,<ref name=Epidemiology /><ref>{{cite journal|last=Lindholm|first=J. |author2=Juul, S. |author3=Jørgensen, J.O.L. |author4=Astrup, J. |author5=Bjerre, P. |author6=Feldt-Rasmussen, U. |author7=Hagen, C. |author8=Jørgensen, J. |author9=Kosteljanetz, M. |author10=Kristensen, L.Ø. |author11=Laurberg, P. |author12=Schmidt, K. |author13=Weeke, J|title=Incidence and late prognosis of Cushing's syndrome: A population-based study|journal=Journal of Clinical Endocrinology and Metabolism|year=2001|volume=86|issue=1|pages=117–123|pmid=11231987|url=http://www.ncbi.nlm.nih.gov/pubmed/11231987|accessdate=January 31, 2014|doi=10.1210/jc.86.1.117}}</ref> with the majority of deaths due to vascular disease <ref name="symptoms" /><ref name=Epidemiology /> Women aged 45–70 years have a significantly higher mortality rate than men.<ref name=Epidemiology /> | The prevalence of [[hypertension]], and abnormalities in [[glucose metabolism]] are major predictors of [[Case fatality rate|mortality]] and [[morbidity]] in untreated cases of the disease.<ref name=Epidemiology /> The mortality rate of Cushing's disease was reported to be 10-11%,<ref name=Epidemiology /><ref>{{cite journal|last=Lindholm|first=J. |author2=Juul, S. |author3=Jørgensen, J.O.L. |author4=Astrup, J. |author5=Bjerre, P. |author6=Feldt-Rasmussen, U. |author7=Hagen, C. |author8=Jørgensen, J. |author9=Kosteljanetz, M. |author10=Kristensen, L.Ø. |author11=Laurberg, P. |author12=Schmidt, K. |author13=Weeke, J|title=Incidence and late prognosis of Cushing's syndrome: A population-based study|journal=Journal of Clinical Endocrinology and Metabolism|year=2001|volume=86|issue=1|pages=117–123|pmid=11231987|url=http://www.ncbi.nlm.nih.gov/pubmed/11231987|accessdate=January 31, 2014|doi=10.1210/jc.86.1.117}}</ref> with the majority of deaths due to vascular disease <ref name="symptoms" /><ref name=Epidemiology /> Women aged 45–70 years have a significantly higher mortality rate than men.<ref name=Epidemiology /> | ||
Moreover, the disease shows a progressive increase with time. Reasons for the trend are unknown, but better diagnostic tools, and a higher incidence rate are two possible explanations.<ref name=Epidemiology/>==References== | Moreover, the disease shows a progressive increase with time. Reasons for the trend are unknown, but better diagnostic tools, and a higher incidence rate are two possible explanations.<ref name=Epidemiology/> | ||
==References== | |||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 16:04, 2 June 2016
Overview
Cushing's disease (also known as Cushing disease, tertiary or secondary hypercortisolism, tertiary or secondary hypercorticism, Itsenko-Cushing disease)[1][2] is a cause of Cushing's syndrome characterised by increased secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary (secondary hypercortisolism). This is most often as a result of a pituitary adenoma (specifically pituitary basophilism) or due to excess production of hypothalamus CRH (Corticotropin releasing hormone) (tertiary hypercortisolism/hypercorticism) that stimulates the synthesis of cortisol by the adrenal glands. Pituitary adenomas are responsible for 80% of endogenous Cushing's syndrome,[3] when excluding Cushing's syndrome from exogenously administered corticosteroids. This should not be confused with ectopic Cushing syndrome or exogenous steroid use.[4]
Epidemiology
Cases of Cushing's disease are rare, and few epidemiological data is available on the disease. An 18 year study conducted on the population of Vizcaya, Spain reported a 0.004% prevalence of Cushing's disease.[5] The average incidence of newly diagnosed cases was 2.4 cases per million inhabitants per year. The disease is often diagnosed 3–6 years after the onset of illness.[5] Several studies have shown that Cushing's disease is more prevalent in women than men at a ratio of 3-6:1, respectively.[6][7] Moreover, most women affected were between the ages of 50 and 60 years. The prevalence of hypertension, and abnormalities in glucose metabolism are major predictors of mortality and morbidity in untreated cases of the disease.[5] The mortality rate of Cushing's disease was reported to be 10-11%,[5][8] with the majority of deaths due to vascular disease [9][5] Women aged 45–70 years have a significantly higher mortality rate than men.[5] Moreover, the disease shows a progressive increase with time. Reasons for the trend are unknown, but better diagnostic tools, and a higher incidence rate are two possible explanations.[5]
References
- ↑ "Whonamedit - Nikolai Mikhailovich Itsenko". "Nikolai Mikhailovich Itsenko investigated neural infections, vegetative nervous system diseases and cerebral tumors. In 1926 he was the first one who described Itsenko-Cushing's disease, six years before Cushing."
- ↑ A.I. Gozhenko, I.P. Gurkalova, W. Zukow, Z. Kwasnik, B. Mroczkowska (2009). "Trematoda". Pathology: Medical Student's Library. Radomska Szkola Wyžsza uk. Zubrzyckiego. p. 280. ISBN 978-83-61047-18-6.
- ↑ Lanzino, Giuseppe; Maartens, Niki F.; Laws, Edward R. (2002). "Cushing's case XLV: Minnie G.". Journal of Neurosurgery. 97 (1): 231–234. doi:10.3171/jns.2002.97.1.0231. PMID 12134925.
|access-date=requires|url=(help) - ↑ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001443/
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Etxabe, J.; J. A. Vazquez (1994). "Morbidity and mortality in Cushing's disease: an epidemiological approach". Clinical endocrinology. 40 (4): 479–484. doi:10.1111/j.1365-2265.1994.tb02486.x. PMID 8187313.
|access-date=requires|url=(help) - ↑ Boggan, J.E; Tyrell, J.B; Wilson C.B (1983). "Transsphenoidal microsurgical management of Cushing's disease: report of 100 cases". Journal of neurosurgery. 95 (2): 195–200. doi:10.3171/jns.1983.59.2.0195.
- ↑ Howlet, T.A; Perry L.; Doniach I.; Rees LH.; Besser G.M (1986). "Diagnosis and management of ACTHdependent Cushing's syndrome: comparison of the features in ectopic and pituitary ACTH production". Clinical endocrinology. 24 (6): 699–713. doi:10.1111/j.1365-2265.1986.tb01667.x. PMID 3024870. Retrieved January 31, 2014.
- ↑ Lindholm, J.; Juul, S.; Jørgensen, J.O.L.; Astrup, J.; Bjerre, P.; Feldt-Rasmussen, U.; Hagen, C.; Jørgensen, J.; Kosteljanetz, M.; Kristensen, L.Ø.; Laurberg, P.; Schmidt, K.; Weeke, J (2001). "Incidence and late prognosis of Cushing's syndrome: A population-based study". Journal of Clinical Endocrinology and Metabolism. 86 (1): 117–123. doi:10.1210/jc.86.1.117. PMID 11231987. Retrieved January 31, 2014.
- ↑