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ISSN 0123-2576 (Print)
Medicina & Laboratorio

2013, Number 09-10

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Medicina & Laboratorio 2013; 19 (09-10)

Clinical and epidemiological features of Cushing’s Syndrome. Medellín, 1986-2010

Gutiérrez RJ, Gómez CJD, Restrepo GLM, Builes BCA, Toro LC, Tobón EAF, Toro EJM, Uribe LF, Latorre SG

Language: Spanish
References: 27
Page: 473-486
PDF size: 1697.28 Kb.


ABSTRACT

Introduction: Although Cushing’s syndrome is an uncommon disease, it is associated with significant morbidity and mortality. Thus far, there are no reports of the clinical and epidemiological characteristics of this entity in our country. Consequently, this study was conducted to analyze data collected over 24 years in 30 patients with Cushing’s syndrome in the city of Medellin, Colombia. Methods: A retrospective descriptive study was conducted to evaluate the diagnostic approach, treatment and outcomes of patients with Cushing’s syndrome between May, 1986 and January, 2010 in the Endocrinology Service at the University of Antioquia and in the Hospital Universitario San Vicente Fundación. Results: We found six cases of ACTH-independent Cushing’s syndrome, four ectopic tumors and 20 tumors of pituitary origin. Regarding biochemical tests, there was statistically significant difference in suppression test with high-dose dexamethasone in Cushing’s disease. Most patients (13) with Cushing’s disease required transphenoidal resection. Only three of nine patients who completed the follow-up were cured. The relapse rate was 69%, with a mean time to reoperation of 17 months. In ACTH independent Cushing’s syndrome, open adrenalectomy was performed in five cases and laparoscopic in one. There were two relapses due to the presence of residual tumor. In ectopic tumors, there was one relapse following tumor resection with resolution after a second surgery. In two cases, there was resolution of hypercortisolism after bilateral adrenalectomy. Conclusions: This review found a lower surgical success rate and a high rate of relapse compared to previous studies, probably due to a lack of experience in the management of sellar and adrenal lesions. Further studies are needed to determine the impact of this disease in Medellin and Colombia, as well as the implementation of interventions to improve patient outcomes.


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