Abstract
In a 11 4/12 years old girl Cushing disease due to pituitary adenoma was diagnosed and confirmed by CT examination.In order to select the pharmacological treatment prior to selective transphenoidal adenomectomy tests with single oral dose of bromocriptine, cyproheptadine and clonidine with RIA estimations of ACTH were performed. The following results were obtained (ACTH serum values in pg/ml):
The probatory treatment with clonidine was not effective. Three months after regular treatment with bromocriptine (7,5mg per day in 5 doses) a dramatic improvement was noticed. Serum cortisol level decreased and its rhythm became normal. A growth spurt, weight loss and lowering of the blood pressure were observed.When the patient was off treatment for 2 1/2 months, serum cortisol concentration increased especially in evening blood samples. She stopped growing, blood pressure increased and she put on weight again. After re-introducing the treatment remarkable improvement occured again.At the age of 12 she had menarche.After ten months of treatment the size of adenoma in CT image did not change, but its density markedly decreased; the patient is closely followed up.
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Romer, T., Ruszczynska-Wolska, A. & Klmaszeweski, J. A case of Cushing disease treated successfully with bromocriptine:A paradoxical response to cyproheptadine. Pediatr Res 18, 1225 (1984). https://doi.org/10.1203/00006450-198411000-00149
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DOI: https://doi.org/10.1203/00006450-198411000-00149