Primary therapy for Cushing's disease with metyrapone
G. Dickstein, M. Lahav, Z. Shen-Orr, Y. Edoute and D. Barzilai
A 13-year-old boy was diagnosed as suffering from pituitary-dependent
Cushing's syndrome. He was treated with 2.0 g of metyrapone daily as the
sole treatment for four years. All clinical and biochemical stigmata of
Cushing's disease disappeared within a few months. The patient grew 23.0 cm
in four years and regained normal health. No significant side effects of
metyrapone were noticed. Administering the medication at 2 PM and 8 PM
allowed higher cortisol levels in the morning and noon hours than in the
evening and night, approximating the normal diurnal variation in cortisol
production. We conclude that metyrapone may be considered the sole
treatment in patients with Cushing's disease.
