Surgical remission of Cushing's disease tied to higher risk of developing autoimmune disease

Researchers from Harvard Medical School identified 194 persons with CD and 92 persons with NFPA, frequency-matched for age and sex, who underwent pituitary surgery. The authors found that persons with CD who achieved remission were more likely than those with surgically treated NFPAs to develop new-onset autoimmune disease within 3 years after remission.

The cumulative incidence was 10.4 percent. According to the authors, higher prevalence of adrenal insufficiency and the lower nadir serum cortisol levels in the CD group suggest that the postoperative adrenal insufficiency might have contributed to the development of autoimmune diseases. They also note that patients with CD who have a family history of autoimmune disease should be carefully monitored after achieving remission. In addition, the authors add that higher doses of early postoperative glucocorticoid replacement might be associated with decreased risk for development of autoimmune disease. These findings have implications for the understanding of the natural history of autoimmune disease and its relationship to cortisol fluctuations.

Reference:

Dennis Delasi Nyanyo, , Masaaki Mikamoto, Francesca Galbiati, Autoimmune Disorders Associated With Surgical Remission of Cushing’s Disease, Annals of Internal Medicine, https://doi.org/10.7326/M23-2024.