Question: I understand that many older patients have joint replacements due to arthritis. It seems many young Cushing’s patients also have joint replacements. Is this due to arthritis or something else? Answer: This is a great question. I have also noticed, anecdotally, that my Cushing’s patients seem to undergo more joint replacements than expected. Unfortunately… Continue Reading
Category Archives: Doctor’s Answers
Predicting Recurrence Based on Post Operative Cortisol and ACTH
Question: Is it possible to predict if a pituitary tumor will recur based on levels of cortisol and ACTH following surgery? Answer: The general answer is “no,” but studies have looked at this question in a number of ways. If a patient is in remission after transsphenoidal surgery for Cushing’s disease, the postoperative cortisol levels,… Continue Reading
MRI Follow up
Question: Post pituitary tumor, if my cortisol tests are normal, do I need an MRI every year? Answer: I do not perform follow up MRI’s in Cushing disease patients if they remain in remission. By Dr. Roberto Salvatori, John Hopkins University, Baltimore, MD, Summer 2015
Glaucoma and Cushing’s
Question: Can Cushing’s cause glaucoma? Are we predisposed to development of glaucoma after remission? Answer: Elevated steroid levels can cause glaucoma, whether due to steroid medications, steroid eye drops, or Cushing’s syndrome. This risk usually declines after the steroid levels fall, such as after remission for Cushing’s syndrome. We do recommend that patients with Cushing’s… Continue Reading
Testing for Recurrence
Question: I am 4 years post pituitary Cushing’s and this year showed an elevated late night salivary cortisol. Are there things other than a recurrence of Cushing’s that could cause a high test result? Can you tell by how high the value is whether it is a recurrence? Answer: First of all, most patients who… Continue Reading
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