NELSON'S SYNDROME: PATHOPHYSIOLOGY, DIAGNOSIS, AND MANAGEMENT STRATEGIES
Keywords:
Keywords: Nelson’s Syndrome, Cushing’s disease, bilateral adrenalectomy, ACTH-secreting pituitary tumor, pituitary macroadenoma, hyperpigmentation, pituitary surgery, radiotherapy, endocrinology, rare diseasesAbstract
Abstract: Nelson’s Syndrome (NS) is a rare but serious complication arising
after bilateral adrenalectomy (BA) in patients with Cushing’s disease. The progressive
enlargement of a pituitary adenoma and excessive secretion of adrenocorticotropic
hormone (ACTH), which can lead to hyperpigmentation, visual disturbances, and
potentially life-threatening complications characterize this condition. Despite advances
in endocrine surgery and pituitary imaging, NS remains a diagnostic and therapeutic
challenge. This article reviews the current understanding of the pathophysiology of NS,
presents clinical findings from recent studies, evaluates diagnostic criteria, and
discusses treatment options including surgery, radiotherapy, and medical therapy. The
study also proposes recommendations for early detection and prevention strategies to
minimize the development of NS post-adrenalectomy.
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