Ping-Yi Hsua, Yi-Ching Tungb, Cheng-Ting Leeb, Fu-Sung Loc, Mu-Zon Wud, Wen-Yu Tsaib, Yong-Kwang Tue
Received 12 November 2009; received in revised form 8 April 2010; accepted 1 May 2010.
Cushing's disease is rare in children and adolescents. We report the clinical presentations of three children with Cushing's disease. All three exhibited the typical symptoms and signs of weight gain and growth retardation.
Two also demonstrated personality changes, hypertension and hypokalemia, the last of these being rarely reported in patients with Cushing's disease. Lack of diurnal changes in serum cortisol levels was the most common biochemical finding. Serum cortisol levels were suppressed by low-dose dexamethasone in one patient, which is not typical for patients with Cushing's disease. Imaging studies are essential for localizing the tumor.
Transsphenoidal surgery remains the treatment of choice, and pituitary irradiation should be considered for those patients whose tumors cannot be totally removed. Careful follow-up of these patients with awareness of the possibilities of relapse and the complications of hypopituitarism is indicated.
a Department of Pediatrics, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan
b Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
c Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
d Department of Pathology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
e Department of Surgery National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
© 2010 Taiwan Pediatric Association. Published by Elsevier Inc. All rights reserved.