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Prevalence of Nelson's syndrome after bilateral adrenalectomy in patients with cushing's disease: a systematic review and meta-analysis

Papakokkinou, Eleni (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, S-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, Bla Straket 5, S-41345 Gothenburg, Sweden.
Piasecka, Marta, 1982 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, S-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, Bla Straket 5, S-41345 Gothenburg, Sweden.
Carlsen, Hanne Krage (author)
University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Department of Environmental and Occupational Health School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Dept Environm & Occupat Hlth, Sch Publ Hlth & Community Med, S-4053 Gothenburg, Sweden.
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Chantzichristos, Dimitrios, 1976 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, S-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, Bla Straket 5, S-41345 Gothenburg, Sweden.
Olsson, Daniel S, 1983 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, S-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, Bla Straket 5, S-41345 Gothenburg, Sweden.
Dahlqvist, Per (author)
Umeå University,Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, S-90187 Umeå, Sweden.
Petersson, M. (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Mol Med & Surg, S-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, S-17176 Stockholm, Sweden.
Berinder, K. (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Mol Med & Surg, S-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, S-17176 Stockholm, Sweden.
Bensing, S. (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Mol Med & Surg, S-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, S-17176 Stockholm, Sweden.
Hoybye, C. (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Mol Med & Surg, S-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, S-17176 Stockholm, Sweden.
Ekman, Bertil, 1958- (author)
Linköpings universitet,Linköping University,Uppsala Univ, Sweden; Uppsala Univ, Sweden,Medicinska fakulteten,Avdelningen för diagnostik och specialistmedicin,Region Östergötland, Endokrinmedicinska kliniken,Linköping Univ, Dept Endocrinol, S-58183 Linköping, Sweden.;Linköping Univ, Dept Med & Hlth Sci, S-58183 Linköping, Sweden.
Burman, Pia (author)
Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Endocrinol, S-20502 Malmö, Sweden.
Follin, Cecilia (author)
Department of Endocrinology, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Endocrinol, S-22242 Lund, Sweden.
Petranek, D. (author)
Department of Endocrinology, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Endocrinol, S-22242 Lund, Sweden.
Erfurth, Eva Marie (author)
Department of Endocrinology, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Endocrinol, S-22242 Lund, Sweden.
Wahlberg, Jeanette, 1969- (author)
Linköpings universitet,Örebro University,Linköping University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden,Medicinska fakulteten,Avdelningen för diagnostik och specialistmedicin,Region Östergötland, Endokrinmedicinska kliniken,Linköping Univ, Dept Endocrinol, S-58183 Linköping, Sweden.;Linköping Univ, Dept Med & Hlth Sci, S-58183 Linköping, Sweden.
Ekman, B. (author)
Akerman, A. K. (author)
Karolinska Institutet,Örebro University,Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, 702 81, Örebro, SE, Sweden,Örebro Univ, Sch Hlth & Med Sci, Dept Internal Med, SE-70281 Örebro, SE, Sweden.
Schwarcz, E. (author)
Örebro University,Örebro Univ, Sch Hlth & Med Sci, Dept Internal Med, SE-70281 Örebro, SE, Sweden.
Johannsson, Gudmundur, 1960 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, S-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, Bla Straket 5, S-41345 Gothenburg, Sweden.
Falhammar, H. (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Mol Med & Surg, S-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, S-17176 Stockholm, Sweden.
Ragnarsson, Oskar, 1971 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal Med & Clin Nutr, S-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, Bla Straket 5, S-41345 Gothenburg, Sweden.
Edén Engström, Britt (author)
Uppsala universitet,Endokrinologi och mineralmetabolism,Uppsala Univ, Uppsala Univ Hosp, Dept Endocrinol & Diabet, S-75185 Uppsala, Sweden.
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 (creator_code:org_t)
2021-05-25
2021
English.
In: Pituitary. - : Springer Science and Business Media LLC. - 1386-341X .- 1573-7403.
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Purpose Bilateral adrenalectomy (BA) still plays an important role in the management of Cushing's disease (CD). Nelson's syndrome (NS) is a severe complication of BA, but conflicting data on its prevalence and predicting factors have been reported. The aim of this study was to determine the prevalence of NS, and identify factors associated with its development. Data sources Systematic literature search in four databases. Study Selection Observational studies reporting the prevalence of NS after BA in adult patients with CD. Data extraction Data extraction and risk of bias assessment were performed by three independent investigators. Data synthesis Thirty-six studies, with a total of 1316 CD patients treated with BA, were included for the primary outcome. Pooled prevalence of NS was 26% (95% CI 22-31%), with moderate to high heterogeneity (I-2 67%, P < 0.01). The time from BA to NS varied from 2 months to 39 years. The prevalence of NS in the most recently published studies, where magnet resonance imaging was used, was 38% (95% CI 27-50%). The prevalence of treatment for NS was 21% (95% CI 18-26%). Relative risk for NS was not significantly affected by prior pituitary radiotherapy [0.9 (95% CI 0.5-1.6)] or pituitary surgery [0.6 (95% CI 0.4-1.0)]. Conclusions Every fourth patient with CD treated with BA develops NS, and every fifth patient requires pituitary-specific treatment. The risk of NS may persist for up to four decades after BA. Life-long follow-up is essential for early detection and adequate treatment of NS.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Keyword

Bilateral adrenalectomy
Cushing’
s disease
Corticotroph adenoma
Nelson’
s syndrome
tumor
Endocrinology & Metabolism
Bilateral adrenalectomy
Cushing’s disease
Nelson’s syndrome

Publication and Content Type

ref (subject category)
art (subject category)

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