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Metyrapone is commonly used in the initial management of Cushing's syndrome to reduce hypercortisolemia, but its optimal dosage and timing can vary significantly between patients. Currently, there are limited guidelines on adjustment methods for its administration to individual needs. This study aimed to evaluate responsiveness of each patient to metyrapone and identify the patient characteristics associated with the indices of cortisol responsiveness following a low-dose metyrapone.

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Introduction: Endocrine paraneoplastic syndromes (ePNS) are caused by malignant cells that induce hormonal alterations unrelated to the tissue of origin of the neoplasm. The aim of this manuscript is to review the pathophysiology, diagnosis, and treatment of endocrine paraneoplastic syndromes (ePNS).

Areas Covered: We searched the PubMed/Medline, Embase, and Scielo databases, including 96 articles.

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Serum Cortisol and Cardiovascular Disease Risk-A Potential Biomarker.

Curr Cardiol Rev

January 2025

Division of Applied Biomedical Science and Biotechnology, School of Health Sciences, IMU University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Cardiovascular Disease [CVD], the leading cause of death globally, poses a significant burden on the healthcare sector. Its association with stress and Cushing's Syndrome has driven cortisol, the 'stress hormone,' to be a potential candidate in determining CVD risk. Cortisol synthesis and release through the hypothalamic-pituitary-adrenal [HPA] axis are regulated by several hormones and receptors involved in the pathological cascade towards CVD.

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Article Synopsis
  • Non-neoplastic hypercortisolaemia, or pseudo-Cushing's syndrome (PCS), can occur due to various health conditions like depression, obesity, and diabetes, linked to overactivity of the hypothalamic-pituitary-adrenal axis.
  • A 66-year-old woman exhibited symptoms such as weakness, weight loss, and poorly controlled hypertension, which led to the discovery of pheochromocytoma, a tumor that causes hormone overproduction, upon further testing.
  • After undergoing surgery to remove the tumor and receiving supportive treatment, her symptoms improved significantly, confirming the diagnosis of PCS rather than traditional Cushing's syndrome.
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Ectopic ACTH syndrome caused by thymic neuroendocrine tumour - stages of treatment.

Endokrynol Pol

December 2024

Department of Endocrinology and Neuroendocrine Tumours, Medical University of Silesia, Katowice, Poland.

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