People with Cushing’s disease have a benign pituitary tumor or pituitary growth that, when triggered, overproduced adrenocorticotropic hormone (ACTH). Too much ACTH causes the body to also overproduce cortisol. Known as the “stress hormone,” cortisol increases blood pressure and regulates inflammation. But in Cushing’s disease, raised cortisol levels lead to mood changes, difficulty concentrating, memory issues, weight gain, stretch marks, fragile bones, muscle weakness, a weakened immune system, menstrual irregularities, and erectile dysfunction.
Cushing’s disease, shares the Cushing’s Support and Research Foundation, is often treated with cortisol inhibitors, chemotherapy, radiation, or surgery. Surgical interventions can lead to remission. However, reports Michael Monostra in Healio, surgical remission could be associated with a heightened risk of developing a new-onset autoimmune disorder.
The Impact of Cushing’s Disease Remission
A cohort study published in the Annals of Internal Medicine sought to explore how often autoimmune diseases occurred after Cushing’s disease surgical remission, as well as what these conditions presented like. To begin, the researchers sourced data from adults who had transsphenoidal surgery over a 14-year period and achieved surgical remission. The researchers found that 194 individuals achieved surgical remission. They then compared this data to 92 individuals who had nonfunctioning pituitary adenomas. According to the researchers:
- After three years, 10.4% of people with Cushing’s disease (after surgical remission) developed a newly-onset autoimmune condition. These included Sjögren’s syndrome, autoimmune seronegative spondyloarthropathy, and autoimmune thyroiditis. Comparatively, only 1.6% of those with nonfunctioning pituitary adenomas developed an autoimmune condition.
- People with Cushing’s disease were also more likely than their counterpoints to have adrenal insufficiency. Researchers suggest that more research is needed to better understand this.
- Larger tumor size, lower body mass index, having a family history of any autoimmune conditions, and lower urine-free cortisol ratios were all associated with a higher risk of developing an autoimmune condition.
Ultimately, the research team suggests that physicians should be aware of these risks. If someone with Cushing’s disease achieves surgical remission, their physicians should keep a close eye on them and any potential symptoms that may arise.
