Persistence of a circadian rhythmicity of glucocorticoid secretion in a patient with Cushing's syndrome: study before and after unilateral adrenalectomy.
A 47-year-old woman affected by Cushing's syndrome due to an adrenal adenoma is described. An altered but rhythmometrically apparent cortisol secretory rhythm was detected using the single-cosinor computation. In fact serum cortisol levels and urinary excretion of 17-OHCS were elevated in the PM hours, particularly between 14:00-18.00 h and 18:00-22:00 h, and normal between 02:00-10:00 h. The patient was cured by unilateral adrenalectomy and one year later the circadian rhythm of corticosteroids secretion was investigated again. A normal rhythm of cortisol secretion and of 17-OHCS urinary excretion was found. Though it may be hypothesized that factors intrinsic to the tumoral adrenal cells were responsible for the rhythmic, but phase-shifted, hormonal release, the cause of the persistent and abnormal cortisol secretory rhythm is unknown.
D015065:17-Hydroxycorticosteroids / Q000378:metabolism / Q000652:urine; D015068:17-Ketosteroids / Q000378:metabolism; D000236:Adenoma / Q000150:complications; D000306:Adrenal Cortex Neoplasms / Q000150:complications; D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D002940:Circadian Rhythm; D003480:Cushing Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery / Q000652:urine; D005260:Female; D005938:Glucocorticoids / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D013997:Time Factors
D015065:17-Hydroxycorticosteroids; D015068:17-Ketosteroids; D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone