Clinical features, diagnosis and treatment outcomes of Cushing's disease in children: A multicenter study
Authors' conclusion
Herein, national data of the clinical experience on paediatric CD have been presented. Our findings highlight that presenting complaints may be subtle in children, the sensitivities of the diagnostic tests are very variable and require a careful interpretation, and MRI fails to detect adenoma in approximately one-third of cases. Finally, clinicians should be aware of the recurrence of the disease during the follow-up after surgery.
Study context
- Population
- Children with Cushing's disease (CD), 15 tertiary centres, December 2015–March 2017M:F = 16:18
- Participants
- 34 children
- Outcome
- Diagnostic tests of CD and tumour size
Methodological detailsnational, multicenter
- National
- Multicenter
Main finding
As reported in the abstract
Sensitivity of late-night serum cortisol for hypercortisolism (most sensitive test)
100%
Sensitivity of morning adrenocorticotropic hormone (ACTH) for pituitary origin (most sensitive test)
96.8%
Adenoma detected on magnetic resonance imaging (MRI)
70.5%
Observational data: associations, not effects.
Further findings
Clinical presentation
- Most frequent complaint: rapid weight gain; most frequent physical finding: round face with plethora
Treatment
- Transsphenoidal adenomectomy (TSA), most preferred treatment
- 78.1%
- Reoperated after TSA due to recurrence or surgical failure
- 6 (24%)
- At follow-up
Original publication
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