PMC:4143611 / 8341-9665
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4143611","sourcedb":"PMC","sourceid":"4143611","source_url":"https://www.ncbi.nlm.nih.gov/pmc/4143611","text":"Whether consideration of post-surgical adrenal insufficiency in conjunction with other parameters predicts recurrence better than post-surgical cortisol levels alone is also unclear. In one study, recovery from transient post-surgical adrenal insufficiency (2–34 months) followed by normalized hypothalamus–pituitary–adrenal (HPA) axis function predicted a low recurrence rate (13 %), whereas lack of a diurnal rhythm of cortisol secretion after normalized adrenal function predicted significantly higher recurrence rates (50–65 %) [28]. In contrast, results from another study showed that the time to complete normalization of the HPA axis following surgery was the only positive indicator of recurrence; all patients who recurred had recovered their HPA axis function within 3 years of surgery [29]. Yet others report that a lower risk of recurrence was associated with normal cortisol suppression by low-dose dexamethasone [30, 31]. Similarly, high levels of ACTH in response to corticotrophin-releasing hormone (CRH) or desmopressin stimulation better predicted relapse than post-operative serum cortisol levels alone [32–36]. As such, it is plausible that patients with subtle abnormalities of the HPA axis following surgery may be at risk for persistent or recurrent hypercortisolemia, which may be mild yet insidious.","tracks":[{"project":"2_test","denotations":[{"id":"24980037-11739423-63233427","span":{"begin":533,"end":535},"obj":"11739423"},{"id":"24980037-23371975-63233428","span":{"begin":797,"end":799},"obj":"23371975"},{"id":"24980037-12744355-63233429","span":{"begin":927,"end":929},"obj":"12744355"},{"id":"24980037-8382119-63233430","span":{"begin":931,"end":933},"obj":"8382119"},{"id":"24980037-7593411-63233431","span":{"begin":1123,"end":1125},"obj":"7593411"},{"id":"24980037-21508126-63233431","span":{"begin":1123,"end":1125},"obj":"21508126"},{"id":"24980037-10913942-63233431","span":{"begin":1123,"end":1125},"obj":"10913942"},{"id":"24980037-11453953-63233431","span":{"begin":1123,"end":1125},"obj":"11453953"},{"id":"24980037-23278711-63233431","span":{"begin":1123,"end":1125},"obj":"23278711"}],"attributes":[{"subj":"24980037-11739423-63233427","pred":"source","obj":"2_test"},{"subj":"24980037-23371975-63233428","pred":"source","obj":"2_test"},{"subj":"24980037-12744355-63233429","pred":"source","obj":"2_test"},{"subj":"24980037-8382119-63233430","pred":"source","obj":"2_test"},{"subj":"24980037-7593411-63233431","pred":"source","obj":"2_test"},{"subj":"24980037-21508126-63233431","pred":"source","obj":"2_test"},{"subj":"24980037-10913942-63233431","pred":"source","obj":"2_test"},{"subj":"24980037-11453953-63233431","pred":"source","obj":"2_test"},{"subj":"24980037-23278711-63233431","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#ecea93","default":true}]}]}}