药物诱发的先天性库欣综合征

Regina G. G. Arroyo, Hannia I. P. Belmontes, Marlene de J. G. Torres, Brizza M. R. Mendoza, Begoña E. Gonzalez, Natalia C. Bonilla, Aran A. R. Ceja, G. G. Santiago
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摘要

药物诱发(先天性)库欣综合征是由于过度或长期接触糖皮质激素所致,糖皮质激素具有抗炎、免疫抑制和促进细胞凋亡的作用,是治疗自身免疫、炎症和血液病的常用药物。尽管这些药物具有治疗作用,但也会导致一系列与内源性库欣综合征相似的多系统症状。本综述旨在阐明先天性库欣综合征的病因、临床表现、诊断和治疗,并强调对可诱发该病的药物的认识。以下综述涵盖皮质醇生理学、库欣综合征病因和亚型、高皮质醇增多症并发症和预后以及糖皮质激素停药策略。本文综述了主要研究结果和建议,强调了先天性库欣综合征诊断和治疗中的挑战和争议。
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Drug induced iatrogenic Cushing’s syndrome
Drug-induced (iatrogenic) Cushing's syndrome results from excessive or prolonged exposure to glucocorticoids, commonly prescribed for autoimmune, inflammatory, and hematological disorders due to their anti-inflammatory, immunosuppressive, and proapoptotic effects. Despite their therapeutic benefits, these medications can lead to a range of multisystemic symptoms mirroring those of endogenous Cushing’s syndrome. This review aims to elucidate the causes, clinical presentation, diagnosis, and management of iatrogenic Cushing's syndrome, emphasizing awareness of medications that can trigger its onset. The following review covers cortisol physiology, Cushing's syndrome etiology and subtypes, hypercortisolism complications and prognosis, and strategies for glucocorticoid withdrawal. This article synthesizes key findings and recommendations, highlighting challenges and controversies in the diagnosis and treatment of iatrogenic Cushing's syndrome.
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