ECE2011 Poster Presentations Adrenal cortex (41 abstracts)
Clinical presentation of Cushing’s syndrome in a large series from the European Registry on Cushing's syndrome (ERCUSYN)
Elena Valassi 1 , Alicia Santos 1 , Maria Yaneva 2 , Miklos Toth 3 , Christian Strasburger 4 , Phillippe Chanson 5 , John Wass 6 , Olivier Chabre 7 , Marija Pfeifer 8 , Richard Feelders 9 , Stylianos Tsagarakis 10 , Peter Trainer 11 , Holger Franz 12 , Kathrin Zopf 4 , Sabina Zacharieva 2 , Steven Lamberts 9 & Susan Webb 1
1IIB-Sant Pau and Department of Endocrinology/Medicine, Hospital Sant Pau, UAB and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, Barcelona, Spain; 2Medical University of Sofia, Sofia, Bulgaria; 3Semmelweis Egyetem, II. Belgyógyászati Klinika, Budapest, Hungary; 4Division of Clinical Endocrinology, Department of Medicine CCM, Charité-Universitätsmedizin, Berlin, Germany; 5Assistance Publique, Hôpitaux de Paris, Paris, France; 6Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK; 7Service d’Endocrinologie-Diabétologie-Nutrition, Grenoble Cedex, France; 8Klinicni center Ljubljana, Ljubljana, Slovenia; 9Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; 10Athens Polyclinic General Hospital and Evangelisnos Hospital, Athens, Greece; 11Department of Endocrinology, Christie Hospital, Manchester, UK; 12Lohmann and Birkner, Berlin, Germany.
The European Registry on Cushing’s syndrome (ERCUSYN) is designed to collect prospective and follow-up data at EU level on patients with Cushing’s syndrome (CS). Baseline data on 481 CS patients (390 females, 91 males; mean age (±S.D.): 44±14 years) collected from 36 centres in 23 countries. This cohort included new patients since 2008 and retrospective cases since 2005. Patients were divided into four major etiologic groups: pituitary-dependent CS (PIT-CS) (66%), adrenal-dependent CS (ADR-CS) (27%), CS from an ectopic source (ECT-CS) (5%) and CS from other etiologies (OTH-CS) (2%). Proportion of men in the ECT-CS group was significantly higher than in the other etiologic groups (P<0.05). Patients in the ADR-CS group were significantly older than those in the PIT-CS group (P<0.05).
Prevalence of hirsutism and diabetes in ECT-CS patients was 92 and 74%, respectively, which was significantly higher as compared with the other etiologic groups (P<0.05 for hirsutism and P<0.01 for diabetes). Patients with PIT-CS had significantly more skin alterations, menstrual irregularities and hirsutism than those with ADR-CS (P<0.01). Reduced libido was more prevalent in men than in women (P<0.01). Prevalence of osteoporosis at spine was significantly higher in men as compared with women (P<0.05), and males had significantly more vertebral and rib fractures than females (52 vs 18% for vertebrae; P<0.001; 34 vs 23% for ribs; P<0.05). Patients with ECT-CS consulted a diabetologist more frequently than those with ADR-CS (P<0.05), while a gynecologist was consulted more often by women with either PIT-CS or ADR-CS than those in the ECT-CS group (P<0.05). Overall, weight gain was significantly more common in women as compared with men (P<0.01). EuroQoL-VAS score in PIT-CS was significantly better than in ADR-CS (P<0.05), while CushingQoL score did not differ between groups. The ERCUSYN project allows an analysis of the heterogeneous clinical presentation and course of CS at a European level, depending on gender and etiology.
Supported by a PHP grant 800200 of the EU.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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