Recurrent Cushing’s disease with low adrenal androgen production

R. J. Louard, R. A. Gelfand

Research output: Contribution to journalArticlepeer-review


A 33 year old woman presented with recurrent Cushing’s disease 4 years after complete remission induced by pituitary surgery. On relapse she exhibited the unusual pattern of elevated indices of Cortisol secretion with markedly suppressed serum DHEA-S; urinary 17-ketosteroid excretion was also below the normal range. Biochemical testing was otherwise consistent with ACTH-mediated hyper-cortisolism, and adrenal histopathology showed bilateral hyperplasia with no evidence of tumor. This case illustrates that serum DHEA-S is not an infallible guide to the differential diagnosis of Cushing’s syndrome, and it supports the existence of a pituitary-secreted adrenal androgen stimulating factor that is distinct from ACTH.

Original languageEnglish (US)
Pages (from-to)965-969
Number of pages5
JournalJournal of endocrinological investigation
Issue number11
StatePublished - Dec 1991
Externally publishedYes


  • ACTH
  • Recurrent Cushing’s disease
  • adrenal androgens
  • dehydroepiandrosterone sulfate (DHEAS)
  • hypercortisolism

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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