{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:29:55Z","timestamp":1770143395330,"version":"3.49.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Surgical therapy represents the first-line treatment for endogenous Cushing\u2019s syndrome (CS). While postoperative glucocorticoid replacement is mandatory after surgical remission, the role of perioperative glucocorticoid therapy is unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We recruited patients with central or adrenal CS in whom curative surgery was planned and patients who underwent pituitary surgery for other reasons than CS as a control group. Patients did not receive any perioperative glucocorticoids until the morning of the first postoperative day. We performed blood samplings in the morning of surgery, immediately after surgery, in the evening of the day of surgery, and in the morning of the first and third postoperative day before any morning glucocorticoid intake. We continued clinical and biochemical monitoring during the following outpatient care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We recruited 12 patients with CS (seven with central CS, five with adrenal CS) and six patients without CS. In patients with CS, serum cortisol concentrations &lt;5.0\u2009\u00b5g\/dL (&lt;138\u2009nmol\/L) were detected in the morning of the first and third postoperative day in four (33%) and six (50%) patients, respectively. Morning serum cortisol concentrations on the third postoperative day were significantly lower when compared to preoperative measurements (8.5\u2009\u00b1\u20097.6\u2009\u00b5g\/dL vs. 19.9\u2009\u00b1\u20098.9\u2009\u00b5g\/dL [235\u2009\u00b1\u2009210\u2009nmol\/L vs. 549\u2009\u00b1\u2009246\u2009nmol\/L], <jats:italic>p<\/jats:italic>\u2009=\u20090.023). No patient developed clinical or biochemical signs associated with hypocortisolism. During follow-up, we first observed serum cortisol concentrations &gt;5.0\u2009\u00b5g\/dL (&gt;138\u2009nmol\/L) after 129\u2009\u00b1\u200997 days and glucocorticoids were discontinued after 402\u2009\u00b1\u2009243 days. Patients without CS did not require glucocorticoid replacement at any time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Perioperative glucocorticoid replacement may be unnecessary in patients with central or adrenal CS undergoing curative surgery as first-line treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12020-024-03832-1","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T12:02:13Z","timestamp":1713787333000},"page":"926-936","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["No requirement of perioperative glucocorticoid replacement in patients with endogenous Cushing\u2019s syndrome \u2013 a pilot study"],"prefix":"10.1007","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4554","authenticated-orcid":false,"given":"Christian","family":"Trummer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"Pandis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-689X","authenticated-orcid":false,"given":"Verena","family":"Theiler-Schwetz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5838-0931","authenticated-orcid":false,"given":"Lisa","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3543-1807","authenticated-orcid":false,"given":"Barbara","family":"Obermayer-Pietsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-0210","authenticated-orcid":false,"given":"Verena","family":"Gellner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Simon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7959-1311","authenticated-orcid":false,"given":"Stefan","family":"Pilz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"3832_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2021.101521","volume":"35","author":"OA Hakami","year":"2021","unstructured":"O.A. 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