Abstract
Objective: Numerous clinical manifestations have been described in association with Cushing's
syndrome. There are no eligible data on pulmonary function tests in Cushing's disease
(CD). We aimed to asses pulmonary function tests including spirometry in a series
of patients with active CD.
Materials and Methods: This cross-sectional study comprised 10 patients with Cushing's disease (F/M, 9/1).
The forced expiratory volume in 1st second (FEV1), the forced vital capacity (FVC),
the FEV1/FVC ratio and the forced expiratory flow over the middle half of the FVC
(FEF 25-75%) values and predicted values were determined by spirometry.
Results: Mean age, height, weight, body mass index were 36.7±12.6 yrs (range 22-63 years),
156.9±8.4 cm, 74.1±10.7 kg, 29.6±3.8 kg/m2, respectively. Spirometric abnormalities (impairment of FEV1, FVC, FEV1/FVC and FEF
25-75 values) were not detected, and there were no significant differences compared
to reference values. Disease duration and cortisol concentrations by HDDSTs were negatively
correlated with predicted FEV1/FVC values and the percentage of predicted FEV1 ratios,
respectively.
Discussion: The lung volume and ventilatory performance by spirometry were not disturbed in patients
with endogenous hypercostisolism due to Cushing's disease.
Key words
Cushing's disease - lung volume - respiratory muscles - spirometry
References
- 1
Etxabe J, Vazquez JA.
Morbidity and mortality in Cushing’s disease: an epidemiological approach.
Clin Endocrinol (Oxf).
1994;
40
479-484
- 2
Arnaldı G, Angelı A, Atkınson AB. et al .
Diagnosis and complications of Cushing’s syndrome: a consensus statement.
J Clin Endocrinol Metab.
2003;
88
5593-5602
- 3
Yanovski JA, Cutler
Jr
GB.
Glucocorticoid action and the clinical features of Cushing’s syndrome.
Endocrinol Metab Clin North Am.
1994;
23
487-509
- 4
American Thoracic Society. European Respiratory Society .
Skeletal muscle dysfunction in chronic obstructive pulmonary disease: a statement
of the American Thoracic Society and European Respiratory Society.
Am J Respir Crit Care Med.
1999;
159
S1-S40
- 5
Laghi F, Tobin MJ.
Disorders of the Respiratory Muscles.
Am J Respir Crit Care Med.
2003;
168
10-48
- 6
Decramer M, Stas KJ.
Corticosteroid induced myopathy involving respiratory muscles in patients with chronic
obstructive pulmonary disease or asthma.
Am Rev Respir Dis.
1992;
146
800-802
- 7
Picado C, Fiz JA, Montserrat JM, Grau JM. et al .
Respiratory and skeletal muscle function in steroid-dependent bronchial asthma.
Am Rev Respir Dis.
1990;
141
14-20
- 8
Voisin C, Fossati P, Wattel F. et al .
La reponse cortico-surrenalienne au cours des episodes de decompensation survenant
chez l’insuffisant respiratoire chronique.
Lille Med.
1970;
15
1367-1374
- 9
Cornil A, Glinoer D, Leclercq R, Copinschi G.
Adrenocortical and somatotrophic secretions in acute and chronic respiratory insufficiency.
Am Rev Respir Dis.
1975;
112
77-81
- 10
Semple Pd’A, Beastall GH, Watson WS, Hume R.
Hypothalamic - pituitary dysfunction in respiratory hypoxia.
Thorax.
1981;
36
605-609
- 11
Gimenez M, Mohan-Kumar T, Humbert JC. et al .
Haematological and hormonal responses to dynamic exercise in patients with chronic
airway obstruction.
Eur J Clin Invest.
1987;
17
75-80
- 12
Kimberly DC, Wardrobe-Wong N, Phillip DS.
Endogenous cortisol and lung damage in a predominantly smoking population.
Am J Respir Crit Care Med.
1999;
159
755-759
- 13
Aron DC, Raff H, Findling JW.
Effectiveness versus efficacy: the limited value in clinical practice of high dose
dexamethasone suppression testing in the differential diagnosis of adrenocorticotropin-dependent
Cushing’s syndrome.
J Clin Endocrinol Metab.
1997;
82
1780-1785
- 14
Miller MR, Hankinson J, Brusasco V. et al .
Standardisation of spirometry.
Eur Respir J.
2005;
26
319-318
- 15
Viires N, Pavlovic D, Pariente R, Aubier M.
Effects of steroids on diaphragmatic function in rats.
Am Rev Respir Dis.
1990;
142
34-38
- 16
Nava S, Gayan-Ramirez G, Rollier H. et al .
Effects of acute steroid administration on ventilatory and peripheral muscles in rats.
Am J Respir Crit Care Med.
1996;
153
1888-1896
- 17
Hopkinson NS, Man WD-C, Dayer MJ. et al .
Acute effect of oral steroids on muscle function in chronic obstructive pulmonary
disease.
Eur Respir J.
2004;
24
137-142
- 18
Decramer M, Lacquet L, Fagard R, Rogiers P.
Corticosteroids contribute to muscle weakness in chronic airflow obstruction.
Am J Respir Crit Care Med.
1994;
150
11-16
- 19
Sparrow D, O’Connor GT, Rosner B. et al .
A longitudinal study of plasma cortisol concentration and pulmonary function decline
in men.
Am Rev Respir Dis.
1993;
147
1345-1348
- 20
Douglass JA, Tuxen DV, Horne M. et al .
Myopathy in severe asthma.
Am Rev Respir Dis.
1992;
146
517-519
- 21
Mills GH, Kyroussis D, Jenkins P. et al .
Respiratory Muscle Strength in Cushing’s Syndrome.
Am J Respir Crit Care Med.
1999;
160
1762-1765
- 22
Polla B, D’Antona G, Bottinelli R, Reggiani C.
Respiratory muscle fibres: specialisation and plasticity.
Thorax.
2004;
59
808-817
- 23
MacLean K, Schurr PH.
Reversible amyotrophy complicating treatment with fludrocortisone.
Lancet.
1959;
1
701-702
Correspondence
T. BayraktarogluMD
Department of Internal Medicine
Division of Endocrinology and Metabolism
Istanbul University, Istanbul Faculty of Medicine
34390 Fatih
Istanbul
Turkey
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