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Surgery Benefits Subclinical Cushing's Syndrome

Resolves clinical and metabolic outcomes

THURSDAY, Dec. 13 (HealthDay News) -- Adrenalectomy often improves clinical and metabolic outcomes in patients with subclinical Cushing's syndrome, according to a study in the December issue of Surgery.

Ian C. Mitchell, M.D., and colleagues from the University of Texas Southwestern Medical Center in Dallas analyzed outcomes among 24 patients who had undergone adrenalectomy for adrenal cortisol hypersecretion. Of these, nine had adrenal cortical hypersecretion but failed to meet the biochemical criteria for Cushing's syndrome (subclinical Cushing's syndrome).

The researchers found that before surgery, patients with subclinical Cushing's syndrome had skin bruising, unexplained weight gain, proximal muscle weakness, abnormal fat pads, skin thinning, fatigue and facial plethora. In a median follow-up five months after surgery, easy bruising had resolved in all affected patients, while fatigue, muscle weakness and weight gain improved in most patients (by a median change in body mass index of -2.0 kg per square meter).

"We conclude that, although the biochemical diagnosis of subclinical Cushing's syndrome remains difficult, many patients with subclinical Cushing's syndrome suffer from comorbidities that resolve often after adrenalectomy," Mitchell and colleagues write.

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