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Endocrine Abstracts (2023) 90 EP101 | DOI: 10.1530/endoabs.90.EP101

ECE2023 Eposter Presentations Adrenal and Cardiovascular Endocrinology (124 abstracts)

Aggravation of depressive symptoms after biochemical cure of Cushing syndrome

Sandra Arbunea-Ghenoiu 1 , Alexandra Piser 1 , Cristina Capatina 1,2 & Catalina Poiana 1,3


1C.I. Parhon national Institute of Endocrinology, Pituitary and Neuroendocrine Pathology, Bucharest, Romania; 2Carol Davila UMPh, Endocrinology, Bucharest, Romania; 3Carol Davila UMPh, Pituitary and Neuroendocrine Pathology, Bucharest, Romania


Introduction: Endogenous Cushing syndrome (CS), is associated with significant morbidity (metabolic, cardiovascular, bone, psychiatric complications among others). Most complications tend to improve if hypercortisolism is controlled but some are only partially reversible or even experience temporary exacerbation.

Patients and Methods: We report 2 cases of adrenal Cushing Syndrome (CS). The first is a 72 years-old female with CS caused by bilateral macronodular adrenal hyperplasia (complicated by diabetes mellitus, arterial hypertension and osteoporosis), treated by bilateral adrenalectomy. The second patient was a 45 years- old female with CS caused by left adrenal adenoma complicated by arterial hypertension and diabetes mellitus, treated by left adrenalectomy.

Results: In the first case the postoperative evolution was complicated by severe gastrointestinal candidiasis (discovered after repetitive episodes of adrenal insufficiency despite adequate replacement with gluco- and mineralcocorticoids) and severe depressive symptoms. These necessitated starting antidepressive medication (tianeptine) with slow control of symptoms over 18 months. In the second case postoperatively the only significant symptom occurring during adequate replacement during the initial months was very severe invalidating depression, slowly improving over several months under treatment with mirtazapine and fluoxetine.

Conclusions: Shortly after successful control of hypercortisolism in certain patients exacerbation or occurrence of serious psychological/psychiatric problems is possible so all patients should be evaluated and followed closely by the endocrinologist which should promptly liaise to psychiatric team whenever needed.

Volume 90

25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

European Society of Endocrinology 

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