Journal of Korean Endocrine Society 1998;13(1):94-98.
Published online January 1, 2001.
A Case of Cughing's Disease which Responded to the Combined Treatment of Ketoconazole and Octreotide.
Chan Soo Shin, Chang Hoon Yim, Jae Jun Koh, Sung Yeon Kim, Bo Yeon Cho, Hong Gyu Lee
The treatment of choice for Cushing's disease is surgical removal of tumor, the source of ACTH overproduction. In occasional patients in whom a surgical approach including total adrenalectomy is not feasible or surgical removal of tumor is not complete, medical treatment may be necessary because pituitary irradiation requires a long 1ag time to remission. Although ketoconazole, an imidazole derivative with inhibitory activity on adrenal steroidogenesis has been reported to be effective in the treatment of Cushing's disease, the limited effectiveness in lowering very high level of cortisol and occasional hepatotoxicity restrains its wide use. In this report, we describe a woman with Cushing's disease due to pituitary microadenoma. Transsphenoidal pituitary adenomeetomy followed by ketoconzole treatment had been unsuccessful in achieving remission of the disease, but combined treatment with ketoconazole and octreotide accomplished successful reduction in cortisol production.
Key Words: Cushing's disease, Combined treatment, Ketoconazole, Octreotide

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