Characteristics of Cushing's syndrome in Taiwanese
Journal
Journal of the Formosan Medical Association
Journal Volume
102
Journal Issue
5
Pages
292-298
Date Issued
2003
Author(s)
Abstract
Background and Purpose: Diagnosis and management of Cushing's syndrome is a challenge to the endocrinologist. This retrospective study investigated the etiology, clinical presentation, treatment and prognosis of endogenous Cushing's syndrome and compared the differences of prognostic factors between Cushing's disease patients with macroadenoma and microadenoma. Methods: Data on disease history, physical examination, and biochemistry of Cushing's syndrome and factors related to the prognosis of Cushing's disease were analyzed. Results: A total of 61 consecutive patients (52 women and 9 men) with endogenous Cushing's syndrome treated from January 1992 to July 2002 were included in this study. They comprised 31 cases of adrenal adenoma, 19 cases of Cushing's disease, 6 cases of ectopic adrenocorticotropin (ACTH) syndrome, 3 cases of adrenal carcinoma, 1 case of macronodular hyperplasia, and 1 case of micronodular hyperplasia. ACTH-independent Cushing's syndrome was the most frequent etiology in this series. The most common symptoms and signs were moon face (89%), weight gain (74%), buffalo hump (74%), and truncal obesity (72%). Hypercholesterolemia was noted in 27 of 45 patients (60.0%) checked for total serum cholesterol level. Elevation of serum lactate dehydrogenase was found in 29 (74.3%) of 39 patients assessed. Patients with adrenal adenoma had the highest cure rate. High residual (2/17, 11.8%) and recurrent rates (5/17, 29.4%) were found in patients with Cushing's disease. There were no significant differences in prognostic factors between Cushing's disease patients with macroadenoma and microadenoma. Conclusions: ACTH-independent Cushing's syndrome was the most frequent type of Cushing's syndrome in this series. The dyslipidemia and elevation of lactate dehydrogenase activity in this series indicated the need for routine laboratory testing in Cushing's syndrome patients. This study found no significant differences in prognostic factors between Cushing's disease patients with macroadenoma and microadenoma.
SDGs
Other Subjects
cholesterol; corticotropin; lactate dehydrogenase; adolescent; adrenal cortex adenoma; adrenal cortex carcinoma; adult; aged; article; cholesterol blood level; controlled study; Cushing disease; Cushing syndrome; data analysis; disease course; dyslipidemia; ectopic corticotropin production; endocrinology; enzyme activity; human; hypercholesterolemia; laboratory test; lactate dehydrogenase blood level; major clinical study; male; medical specialist; microadenoma; moon face; nodular hyperplasia; obesity; physical examination; prognosis; recurrence risk; retrospective study; symptomatology; Taiwan; weight gain; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adult; Aged; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Recurrence; Retrospective Studies; Taiwan
Type
journal article