title: [Inflammatory rheumatism flare-up after surgical treatment of Cushing's disease: two cases].
abstract: The anti-inflammatory effect of natural glucocorticoids is often overlooked, as shown by these two cases of inflammatory rheumatism flare-up which occurred after surgical treatment of Cushing's syndrome. The disorder in the first case was exacerbation of a probable rheumatoid arthritis; in the second case an unlabelled inflammatory rheumatism appeared in a context of postoperative corticotropic deficiency. In both cases a purely substitutive hydrocortisone therapy resulted in dramatic regression of the articular symptoms. It is well known that rheumatismal manifestations may occur in patients with slow adrenal failure. The determinant factor seems to be a glucocorticoid deficiency, either isolated or associated with others, since cortisol exerts and anti-inflammatory activity. In patients with corticotropic deficiency following surgical treatment of Cushing's disease, the endogenous corticosteroid therapy of hypercortisolism is interrupted, allowing the aggravation or emergence of inflammatory rheumatism.
authors.affiliation: Service de Médecine Interne et de Nutrition, CHU Timone, Marseille.
authors.forename: D
authors.initials: D
authors.lastname: Raccah
authors.forename: C
authors.initials: C
authors.lastname: Zeitoun
authors.forename: P
authors.initials: P
authors.lastname: Lafforgue
authors.forename: V
authors.initials: V
authors.lastname: Lassmann-Vague
authors.forename: B
authors.initials: B
authors.lastname: Mallet
authors.forename: B
authors.initials: B
authors.lastname: Vialettes
authors.forename: P J
authors.initials: PJ
authors.lastname: Weiller
authors.forename: P
authors.initials: P
authors.lastname: Vague
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D003480:Cushing Syndrome / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D011183:Postoperative Complications; D011859:Radiography; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*
chemical_list: D006854:Hydrocortisone
vernacular_title: Poussée de rhumatisme inflammatoire après cure chirurgicale d'une maladie de Cushing: deux cas.