TAILIEUCHUNG - Cushing’s Disease in Children: Report of Three Cases

For health professionals to effectively protect children from environmental threats, specialized training is useful. Evidence shows that health providers are generally not provided the training that they need to address the complex environmental health issues with respect to air, water, soil, and products (Pope & Rall, 1995) Diarrhoeal diseases often recur frequently when underlying causes such as contaminated water are not taken into account by the health provider, understood by the community or adequately addressed by governments. . | Pediatr Neonatol 2010 51 5 303-307 ELSEVIER CASE REPORT Cushing s Disease in Children Report of Three Cases Ping-Yi Hsu1 Yi-Ching Tung2 Cheng-Ting Lee2 Fu-Sung Lo3 Mu-Zon Wu4 Wen-Yu Tsai2 Yong-Kwang Tu5 1Department of Pediatrics National Taiwan University Hospital Yun-Lin Branch Yun-Lin Taiwan 2Department of Pediatrics National Taiwan University Hospital and College of Medicine National Taiwan University Taipei Taiwan 3Department of Pediatrics Chang Gung Memorial Hospital Taoyuan Taiwan 4Department of Pathology National Taiwan University Hospital and College of Medicine National Taiwan University Taipei Taiwan 5Department of Surgery National Taiwan University Hospital and College of Medicine National Taiwan University Taipei Taiwan Received Nov 12 2009 Revised Apr 8 2010 Accepted May 1 2010 KEY WORDS Cushing s syndrome Cushing s disease hypokalemia 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. 1. Introduction Cushing s syndrome or hypercortisolism describes the clinical manifestations of glucocorticoid excess from any sources. Cushing s disease specifically refers to .

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