Objective: Cushings disease (CD) accounts for approximately 80% of cases of Cushings syndrome. Its clinic is nonspecific and its diagnosis difficult. The objective of this study is to review the most frequent clinical signs of this disease in our environment and compare it with that described in the literature.
Patients and methods: Retrospective descriptive study of patients with CD. We included all patients diagnosed with CD (20052017) treated with transsphenoidal surgery, and whose tumor sample was analyzed in the Department of Cell Biology, Physiology and Immunology of the University From Córdoba. Variables analyzed: age, sex, body mass index (BMI), reason for consultation, clinical presentation and time to diagnosis. The data obtained were compared with those described in the literature. Statistical analysis (SPSS v.18.0 for Windows): t-student for comparison of means and McNemar for comparison of proportions.
Results: Thirty-seven patients with CD. Age 45.03±13.13 years. Women: 94.6% %. Cyclic EC: 10.8%. Time to diagnosis: 40.96±31.91 months. Most frequent reason for consultation: suspected cushing syndrome (24.3%), obesity and overweight (24.3%) and type 2 diabetes (DM-2). BMI: 32.91±7.06 kg/m2. Clinical presentation: central obesity 90.9%, asthenia 93.1% (P=0.001), menstrual disorders 46.2% (P=0.000), face of a full moon 93.5%, cutaneous atrophy 85%, cervical lipomatosis 89.3%, muscular atrophy 84.6%, fragile capillary 56.3%, hirsutism 83.3%, raclavicular fat 87.5%, stretch marks 57.1%, acne 63.6% and edema 46.2%. Comorbidities: arterial hypertension 62.2%, osteoporosis 50% (8.3% atypical fracture), dyslipidemia 37.8%, DM-2 43.2% (P=0.02), depression 34.6%, infections 8.3% (P=0.03), gastric ulcus 14% and stroke 2.7%.
Conclusions: CD is more frequent in women, predominating in the fourth decade. Clinic present in our series is very similar to that described in the literature. Only significant differences were seen with the published series on the appearance of menstrual disorders, diabetes mellitus and infections, which is higher in the literature. The presence of asthenia is greater in our series.
18 - 21 May 2019
European Society of Endocrinology