Abstract
Symptoms of Cushing's disease are developping faster and more characteristically in children than in older patients. This study analizes physical and endocrine findings establishing the diagnosis of pituitary ACTH producing adenomas in 34 children (21 girls and 13 boys). They were operated by transsphenoidal route (successful in 31 children) during 1980 and 1992 at an age of 14.3+/-2.9 (SD), range: 6-18 years. - Unexplained weight gain (60.3+/-17.8, r:35-102 kg, SDS for CA +0.9 +/-1,2) was more freguently complained than growth retardation (148.8+/-13.8,r:119-176 cm, SDS for CA -2.2 +/-2.7),. although decreased height SDS and low height velocity (2.2+/-1.9 cm/y) was calculated in all but 3 children. Minimal (164+/-103 ug/l) and maximal plasma cortisol (337+/-153 ug/l) were elevated as well as corresponding ACTH levels (61+/-43 and 123+/-82 ng/l, respectively). CRF stimulated cortisol and ACTH was 429 +/-243 ug/l and 300+/-301 ng/l, respectively in all except 2 cases. Dexamethasone-test and free urine cortisol were less informative.
Conclusion: Impaired growth, increased weight gain, elevated basal and stimulated cortisol and ACTH plasma levels are the most reliable findings in Cushing's disease during childhood.
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Willig, R., Demuth, K. & Lüdecke, D. PHYSICAL AND ENDOCRINE FINDINGS IN CUSHING'S DISEASE OF CHILDREN TREATED BY TRANSSPENOIDAL OPERATION. Pediatr Res 33 (Suppl 5), S23 (1993). https://doi.org/10.1203/00006450-199305001-00120
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DOI: https://doi.org/10.1203/00006450-199305001-00120