Endocrine Abstracts

Introduction: To analyze clinical, laboratory and anamnestic data of the patients with Cushing’s disease (CD) we conducted a CD database.

Methods: One hundred and eighty patients with CD were investigated in MRRCI from 1975 year. To all of them in 2011 the invitation letter was sent. In only 22 patients we could confirm diagnosis of CD according to their medical documentation. Three patients died to 2011. From 2009 to 2012 in 16 patients CD were newly diagnosed. So, now in our database 38 pat. (35- female, 3 male) with laboratory and histologically confirmed CD.

Results: The age of patients at diagnosis were 39.2±12.1 y.o. Duration of their complaints – 36 (22;75) mo. BMI – 34.2±6.8, 71.5% of patients were obese. One patient noted weight decreasing. In 15.7% of cases relatives of the pat. had malignancies, in 13% – endocrine diseases. In 42% of patients additional endocrine diseases revealed. In 48% of pat. glucose intolerance was newly diagnosed (17% – glucose intolerance, 83% – DM). In all patients pathology of cardiovascular system were find (hypertension – 100% (sBP – 187±30, dBP – 110±16), heart failure – 11%, MI – 3%). Pulmonary embolism – 5%. Gastrointestinal diseases – 83%, urinary tract diseases – 24% (urolithiasis – 11%). Psychiatric disoders – 42.1%. Osteoporosis – 24%, osteopenia – 38%. Skin affection – 53% (mostly pityriasis versicolor). Infections of various organs – in 72% of patients. Laboratory changes. UFC was high in 66%, cortisol level after LDDST – 618,3±318,9 nmol/l. Mean of cortisol suppression after HDDST – 80,9±18,1%, suppression more then 50% revealed in 96% of pat. Pituitary MRI revealed macroadenoma in 14%, micro – 55%, no abnormalities – 31%. Treatment. The only neurosurgery (N) was done to 15 pat., radiotherapy only (R) – 5 pat., N+R – in 2 pat. Adrenalectomy +N/or R – in 14 pat. One pat. refused from surgical treatment and receive medication. Efficacy. Secondary adrenal insufficiency – 61%, remission – 13%. Relapse of CD – 23%. 1 pat. (3%) died before treatment.

Conclusion: The database shows high prevalence of different complications of CD, endocrine and non endocrine diseases in relatives, effectiveness of treatment. High prevalence of relapse after treatment tend to lifelong monitoring of the patients.