Pseudo‐Cushing's Syndrome in Human Immunodeficiency Virus– Infected Patients

Miller, Karen K.; Daly, Patricia; Sentochnik, Deborah E.; Doweiko, John P.; Samore, Matthew; Basgoz, Nesli; Grinspoon, Steven

doi:10.1086/514638

Cited by 154 publications

(67 citation statements)

References 2 publications

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“…The distribution of fat accumulation in HAL is similar to that induced by increased plasma glucocorticoid levels in Cushing's syndrome. However, circulating cortisol concentrations are not elevated in HAL patients [2].…”

Section: Short Communicationmentioning

confidence: 86%

In the lipodystrophy associated with highly active antiretroviral therapy, pseudo-Cushing?s syndrome is associated with increased regeneration of cortisol by 11?-hydroxysteroid dehydrogenase type 1 in adipose tissue

et al. 2004

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Aims/hypothesis. Highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus (HIV) is associated with a poorly understood lipodystrophic and hypertriglyceridaemic syndrome, which resembles Cushing's syndrome, but in which plasma cortisol is not elevated. We tested the hypothesis that this HAART-associated lipodystrophy is explained by increased local regeneration of cortisol from inactive cortisone within adipose tissue, catalysed by the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Methods. In this cross-sectional study, a previously described cohort of 30 HIV-infected patients with lipodystrophy were compared with 13 HIV-infected patients without lipodystrophy. Intra-abdominal and subcutaneous adipose tissue were quantified using magnetic resonance imaging. Gene expression in subcutaneous fat was measured using real-time PCR. Urine cortisol and its metabolites were analysed by gas chromatography/mass spectrometry.

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Section: Short Communicationmentioning

confidence: 86%

In the lipodystrophy associated with highly active antiretroviral therapy, pseudo-Cushing?s syndrome is associated with increased regeneration of cortisol by 11?-hydroxysteroid dehydrogenase type 1 in adipose tissue

et al. 2004

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“…Leptin affects both cellmediated and humoral immunity [150][151][152][153]. Leptin has been shown to have direct effects on cells of the innate immune system, upregulating phagocytic function in macrophages, stimulating pro-inflammatory cytokine secretion and stimulating chemotaxis in polymorphonuclear cells.…”

Section: Adipokinesmentioning

confidence: 99%

Metabolic Disorders in HIV-infected Children Metabolic Disorders in HIVinfected Children

Liguoro¹

2014

J Metabolic Synd

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The introduction of highly active antiretroviral therapy (HAART) for the treatment of acquired immunodeficiency syndrome (AIDS) has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV). However, the use of these drugs has been associated with lipodystrophic syndrome (LS), which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis) and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohypertrophy (accumulation of fat in the central part of the body), lipoatrophy (loss of fat in the extremities, face and buttocks) and mixed (lipohypertrophy + lipoatrophy). Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS are also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

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“…Since the clinical manifestations of this syndrome closely resemble those of chronic glucocorticoid excess as seen in Cushing's syndrome, the term 'pseudo-Cushing' was initially used to describe this syndrome. 62 However, HPA axis hyperactivity, which is commonly seen in HIV-infected patients, seems to be an unlikely cause of ARIRLS. These patients have normal baseline (and CRH-stimulated) ACTH and cortisol values concomitantly with normal excretion of 24-h urinary free cortisol.…”

Section: Autopsy Findingsmentioning

confidence: 99%

Dysfunction of the Hypothalamic-Pituitary-Adrenal axis in HIV infection and disease

Zapanti¹,

Terzidis²,

Chrousos³

2008

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Pseudo‐Cushing's Syndrome in Human Immunodeficiency Virus– Infected Patients

Cited by 154 publications

References 2 publications

In the lipodystrophy associated with highly active antiretroviral therapy, pseudo-Cushing?s syndrome is associated with increased regeneration of cortisol by 11?-hydroxysteroid dehydrogenase type 1 in adipose tissue

In the lipodystrophy associated with highly active antiretroviral therapy, pseudo-Cushing?s syndrome is associated with increased regeneration of cortisol by 11?-hydroxysteroid dehydrogenase type 1 in adipose tissue

Metabolic Disorders in HIV-infected Children Metabolic Disorders in HIVinfected Children

Dysfunction of the Hypothalamic-Pituitary-Adrenal axis in HIV infection and disease

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