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Work-up and management of paediatric Cushing's syndrome

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From http://www.co-endocrinology.com/pt/re/coen...#33;8091!-1


Work-up and management of paediatric Cushing's syndrome



Fulltext | PDF (139 K) Work-up and management of paediatric Cushing's syndrome.



Current Opinion in Endocrinology, Diabetes & Obesity. 15(4):346-351, August 2008.

Savage, Martin O; Chan, Li F; Grossman, Ashley B; Storr, Helen L Abstract:

Purpose of review: Paediatric Cushing's syndrome presents a diagnostic and therapeutic challenge. Most paediatric endocrinologists have limited experience in managing children or adolescents with Cushing's syndrome and thus benefit from close consultation with adult colleagues. A protocol for investigation of the child with suspected Cushing's syndrome is presented followed by principles of management.


Recent findings: Cushing's syndrome is rare in childhood, but causes serious morbidity. Investigations have evolved and now include new genetic and imaging techniques as well as classical endocrine studies. In Cushing's disease trans-sphenoidal surgery has transformed management, although only a few surgeons have experience in children. Pituitary radiotherapy is effective second-line therapy.


Summary: Early diagnosis and treatment of Cushing's syndrome is vital for long-term outcome. The overall prognosis for Cushing's syndrome is good but challenges remain to ensure normal postcure growth and body composition.


© 2008 Lippincott Williams & Wilkins, Inc.

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