Quality of Life in Cushing's disease: A long term issue?

Susan M. Webb, Alicia Santos, Eugenia Resmini, Maria Antonia Martínez-Momblán, Luciana Martel, Elena Valassi

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Abstract

© 2018 Elsevier Masson SAS The purpose of this review is to describe how quality of life (QoL) is impaired in patients with hypercortisolism due to Cushing's syndrome of any aetiology, including pituitary-dependent Cushing's disease. It is worse in active disease, but improvement after successful therapy is often incomplete, due to persistent physical and psychological co-morbidities, even years after endocrine “cure”. Physical symptoms like extreme fatigability, central obesity with limb atrophy, hypertension, fractures, and different skin abnormalities severely impair the affected patients’ everyday life. Psychological and cognitive problems like bad memory, difficulties to concentrate and emotional distress, often associated with anxiety and depression, make it difficult for many patients to overcome the aftermath of treated Cushing's syndrome. Recent studies have shown diffuse structural abnormalities in the central nervous system during active hypercortisolism, thought to be related to the wide distribution of glucocorticoid receptors throughout the brain. Even though they improve after treatment, normalization is often not complete. Shortening the exposure to active Cushing's syndrome by reducing the often long delay to diagnosis and promptly receiving effective treatment is highly desirable, together with preparing the patient for the difficult periods, especially after surgery. In this way they are prepared for the impairments they perceive in every day life, and live with the hope of later improvement, which can be therapeutic in many instances.
Original languageEnglish
Pages (from-to)132-137
JournalAnnales d'Endocrinologie
Volume79
Issue number3
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • Anxiety
  • Coping
  • Cushing's syndrome
  • Depression
  • Persistent co-morbidities
  • Quality-of-life impairment

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    Webb, S. M., Santos, A., Resmini, E., Martínez-Momblán, M. A., Martel, L., & Valassi, E. (2018). Quality of Life in Cushing's disease: A long term issue? Annales d'Endocrinologie, 79(3), 132-137. https://doi.org/10.1016/j.ando.2018.03.007