Six year remission of ACTH-dependent Cushing's syndrome using bromocriptine

Abstract

Summary A patient with ACTH-dependent Cushing's syndrome remained in clinical and biochemical remission six years after pituitary irradiation and while on bromocriptine therapy. When bromocriptine was discontinued urinary free cortisol values became elevated, and were not suppressed by dexamethasone. After reintroduction of the drug, remission was again obtained. It is concluded that bromocriptine is responsible for continuing longterm remission in this case. The possible use of bromocriptine as an adjunctive therapy in ACTH-dependent Cushing's syndrome is discussed.

The treatment of Cushing's syndrome

“…Pharmacological agents directed at ACTH secretion in Cushing's disease are rarely of value. There have been sporadic reports of the use of cyproheptadine and bromocriptine in hypercortisolism (Krieger et al, 1975;Lamberts et al 1980b;Atkinson et al, 1985a;Whitehead et al, 1990). In our recent experience we have found that neither cyproheptadine nor bromocriptine, nor a combination of the two, effectively reduces ACTH secretion following bilateral adrenalectomy (Whitehead et al, 1990), and we have also founa them ineffective in cases of cyclical Cushing's syndrome (Atkinson et al, 1985b).…”

Endocrine clinical update: Where are we in the therapeutic management of pituitary‐dependent hypercortisolism?

“…[78][79][80][81] Bromocriptine has been reported to be successful in cases associated with both normal and elevated serum prolactin levels. [82][83][84][85][86][87][88][89] However, it is possible that publication bias towards reports of success may skew the overall picture and no controlled trials have been published. Invitti et al .…”

Bromocriptine-Responsive Cushing's Disease; Clinical and Biochemical Remission Accompanied by Amelioration of Impaired Ocular Movement

“…However, trials in series of consecutive patients revealed that only fewer than 25% of unselected patients respond to bromocriptine. A clinical response to low-dose (less than 10 mg) bromocriptine in 15 cases has been reported thus far (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), while tumor shrinkage has been reported in only 3 cases (9,16,18) (Table 2).…”