[Nelson's syndrome management: current knowledge].
OBJECTIVE
Nelson's syndrome is a severe complication of bilateral adrenalectomy performed in the treatment of some Cushing's diseases, and its management remains difficult. Trough the observation of a patient suffering from a severe form of Nelson's syndrome for more than 10 years, the authors review the literature and discuss the main current therapeutic possibilities.


BACKGROUND
Many molecules have been used with variable results. In our observation cabergoline at 2 mg per week seems to be efficient after a 3 and a half years follow-up, in accordance with some recent publications. More than bromocriptine, this dopamine agonist provides interesting prospects for this disease's management. Moreover, if the conventional treatments as valproic acid or cyproheptadine are not very efficient, somatostatin analogs seem to be of some therapeutic interest.


CONCLUSIONS
New molecules are currently evaluated, but studies are difficult to conduct because of the low disease prevalence. Tumour receptors analysis undoubtedly constitutes an attractive way to find new therapeutic targets.
Garcia
C
C
Service d'endocrinologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France. cygarcia@wanadoo.fr
Bordier
L
L
Garcia-Hejl
C
C
Ceppa
F
F
Mayaudon
H
H
Dupuy
O
O
Bauduceau
B
B
D000293:Adolescent; D000315:Adrenalectomy / Q000009:adverse effects*; D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis; D003480:Cushing Syndrome / Q000150:complications / Q000601:surgery; D003533:Cyproheptadine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D009347:Nelson Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
D006634:Histamine H1 Antagonists; D003533:Cyproheptadine; D000324:Adrenocorticotropic Hormone