Abstract
A DEFECT IN ]tYPOTHALAMIC REGULATION of A C T H secretion has been postulated as the primary abnormality in Cushing disease, which subsequently leads to adrenocortical hyperplasia, with or without an ACTl t secre t ing pituiiary adenoma. Cyproheptadine is a centrally acting serotonin antagonist that can block A C T H release, and has been reported to induce remission of Cushing disease in adults, j However, in only a few cases have these remissions been sustained after cessation of therapy. 24 Cyproheptadine therapy has not been widely accepted for use in children, and has been reported either to be ineffective 5 or only a useful adjunct to adrenalectomy) ~ We describe successful primary treatment of Cushing disease in a child who has shown sustained remission for 3 years since therapy has been discontinued.
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