دورية أكاديمية
Low-dose etomidate for the management of severe hypercortisolaemia in different clinical scenarios: a case series and review of the literature
| العنوان: | Low-dose etomidate for the management of severe hypercortisolaemia in different clinical scenarios: a case series and review of the literature |
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| المؤلفون: | Agnieszka Łebek-Szatańska, Karolina M. Nowak, Wojciech Zgliczyński, Elżbieta Baum, Agnieszka Żyłka, Lucyna Papierska |
| المصدر: | Therapeutic Advances in Endocrinology and Metabolism, Vol 10 (2019) |
| بيانات النشر: | SAGE Publishing, 2019. |
| سنة النشر: | 2019 |
| المجموعة: | LCC:Diseases of the endocrine glands. Clinical endocrinology |
| مصطلحات موضوعية: | Diseases of the endocrine glands. Clinical endocrinology, RC648-665 |
| الوصف: | Background: Severe Cushing’s syndrome (SCS) is associated with acute cardiovascular, metabolic and infectious complications. It is considered an emergency, requiring an immediate diagnosis, together with a broad spectrum of supportive and hypocortisolaemic treatments. Surgical intervention, aimed at removing the source of cortisol or adrenocorticotropic hormone (ACTH), is the optimal treatment in most cases of Cushing’s syndrome. However, in hypercortisolaemic states, surgical intervention has high rates of perioperative mortality and morbidity. Oral adrenal steroidogenesis inhibitors, even if more effective in combination, are not always efficient enough or well tolerated. Despite their common use, a more potent, parental, immediate, and thus life-saving, therapy is necessary. Methods: The authors present three different clinical scenarios of etomidate treatment in patients hospitalized in the third reference endocrinological centre in Poland between 2016 and 2017. Results: Patients with Cushing’s disease, ectopic Cushing’s syndrome and adrenocortical carcinoma presented with severe hypercortisolaemia and exacerbated cortisol-dependent comorbidities. In these three cases, etomidate acted as an accurate, well tolerated and effective cortisol-lowering drug for several days or even months. Patients were monitored in a general ward setting, and no side effects of the therapy were observed. Conclusions: In doses far lower than those used for anaesthesia, etomidate works as a useful cortisol-lowering therapy in patients intolerant to or unable to take oral medications. Additionally, if urgent, the most potent and effective medical intervention is necessary, and clinicians should be aware of such a therapeutic option. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2042-0196 20420188 41442318 |
| العلاقة: | https://doaj.org/toc/2042-0196Test |
| DOI: | 10.1177/2042018819825541 |
| الوصول الحر: | https://doaj.org/article/f7dab06fa41442318a0c30e86a783db3Test |
| رقم الانضمام: | edsdoj.f7dab06fa41442318a0c30e86a783db3 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 20420196 20420188 41442318 |
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| DOI: | 10.1177/2042018819825541 |