Endocrine Abstracts

Objective: To summarise and analyze the pathogenesis, clinical risk assessment, and treatment of venous thromboembolic events (VTE) associated with Cushing syndrome (CS), and to improve clinicians’ understanding of this complication.

Methods: The clinical diagnosis and treatment of 3 patients with Cushing disease (CD) combined with pulmonary embolism were reviewed, and relevant literature at home and abroad was reviewed.

Results: Three patients, all female, were diagnosed with CD and underwent resection of the saddle region. Three-dimensional reconstruction of pulmonary arterial vessels on the 6th day after the operation indicated pulmonary embolism, and they were treated with low molecular heparin and rivaroxaban anticoagulant therapy successively, and the CTA of the pulmonary artery was reexamined after 3 months without any abnormality. The keywords "Cushing’s disease, Cushing’s syndrome" and "pulmonary embolism, venous thromboembolism" were searched. A total of 73 articles were retrieved from the Pubmed database, of which 28 were case reports, 10 were reviews, and 35 were clinical studies. The risk of VTE in CS is more than 10 times higher than that in the general population, and the pathogenesis and clinical risk assessment are complex, while the duration of prophylactic anticoagulation and its protocols have not yet reached a consensus.

Conclusion: CS is associated with multisystem complications. The risk of VTE in CS is significantly higher, with a rapid onset of disease and a high mortality rate. Clinical vigilance, avoidance, and screening of CS-related complications are needed for early diagnosis and treatment.