{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T23:14:45Z","timestamp":1777072485339,"version":"3.51.4"},"reference-count":76,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Aim of our study was to analyze long-term outcome of patients with the ectopic Cushing\u2019s syndrome (ECS) compared to patients with Cushing\u2019s disease (CD) regarding cardiovascular, metabolic, musculoskeletal and psychiatric comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study in patients with ECS and CD in two German academic tertiary care centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Standardized clinical follow-up examination was performed including health-related quality of life (QoL) in 21 ECS patients in long-term remission (\u226518 months since successful surgery). Fifty-nine patients with CD in remission served as controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Time from first symptoms to diagnosis of Cushing\u2019s syndrome (CS) was shorter in ECS than in CD (8.5 (IQR: 30.3) vs 25 (IQR: 39.0) months,<jats:italic>P<\/jats:italic>\u2009=\u20090.050). ECS patients had lower self-reported psychiatric morbidity compared to CD (19% vs 43%,<jats:italic>P<\/jats:italic>\u2009=\u20090.050) at follow-up. Moreover, female ECS patients reported favorable scores for QoL in the SF-36 questionnaire (mental health: 92 (IQR: 30) vs 64 (IQR: 32) in CD,<jats:italic>P<\/jats:italic>\u2009=\u20090.010) and a Cushing-specific QoL questionnaire (73 (IQR: 18) vs 59 (IQR: 36) in CD,<jats:italic>P<\/jats:italic>\u2009=\u20090.030). In a pooled analysis of ECS and CD patients, QoL correlated with time from first symptoms until diagnosis of CS, but not with urinary free cortisol levels or serum cortisol after dexamethasone at the time of diagnosis. Long-term outcomes regarding hypertension, metabolic parameters, bone mineral density and grip strength were comparable in ECS and CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data support the concept that time of exposure to glucocorticoid excess appears to be a better predictor than peak serum cortisol levels at the time of diagnosis regarding long-term psychiatric morbidity and QoL.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-18-0212","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T16:20:52Z","timestamp":1528302052000},"page":"109-116","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":31,"title":["Surviving ectopic Cushing\u2019s syndrome: quality of life, cardiovascular and metabolic outcomes in comparison to Cushing\u2019s disease during long-term follow-up"],"prefix":"10.1093","volume":"179","author":[{"given":"Andrea","family":"Osswald","sequence":"first","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[{"name":"2Endocrine and Diabetes Unit, Department of Internal Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina M","family":"Berr","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Plomer","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Mickisch","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Ritzel","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Schopohl","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"},{"name":"3Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische Ern\u00e4hrung, Universit\u00e4tsSpital Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"2Endocrine and Diabetes Unit, Department of Internal Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Hahner","sequence":"additional","affiliation":[{"name":"2Endocrine and Diabetes Unit, Department of Internal Medicine I, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"ref521","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1530\/EJE-16-0689","article-title":"Persistence of myopathy in Cushing\u2019s syndrome: evaluation of the German Cushing\u2019s Registry","volume":"176","year":"2017","journal-title":"European Journal of Endocrinology"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1530\/EJE-17-0048","article-title":"Health-related quality of life of patients with hypothalamic-pituitary-adrenal axis dysregulations: a cohort study","volume":"177","year":"2017","journal-title":"European Journal of 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