Glucocorticoid withdrawal syndrome following surgical remission of endogenous hypercortisolism: a longitudinal observational study
Authors' conclusion
Glucocorticoid withdrawal symptoms are prevalent and persistent following surgical remission of hypercortisolism with baseline CS clinical severity predictive of postoperative GWS symptom burden. Differential changes observed in muscle function and quality of life in the early postoperative period may reflect the competing influences of GWS and recovery from hypercortisolism.
Study context
- Population
- Patients after surgical remission of endogenous hypercortisolism
- Exposure
- 12 weeks after surgery vs baseline
- Outcome
- Presence and trajectory of glucocorticoid withdrawal symptoms
- Follow-up
- Weekly for first 12 weeks postoperatively
Methodological detailsprospective weekly symptom evaluation
- Prospective weekly symptom evaluation
Main finding
As reported in the abstract
- Myalgias and arthralgias
- 50%
- Fatigue
- 45%
- Weakness
- 34%
- Sleep disturbance
- 29%
- Mood changes
- 19%
Observational data: associations, not effects.
Further findings
Normative hand grip strength, 12 weeks vs baseline
- Weaker; mean Z-score delta (P = .009)
- −0.37
Normative sit-to-stand test performance, 12 weeks vs baseline
- Improved; mean Z-score delta (P = .013)
- 0.50
Short-Form-36 Physical Component Summary, 12 weeks vs baseline
- Worsened; mean delta (P = .015)
- −2.6
CushingQoL score, 12 weeks vs baseline
- Improved; mean delta (P < .001)
- 7.8
Presurgical predictors of glucocorticoid withdrawal syndrome (GWS) severity
- Cushing syndrome (CS) clinical severity was predictive of postoperative GWS symptomology
Original publication
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