[Cushing's syndrome: clinical study of fifteen cases].
OBJECTIVE
To study the epidemiological and clinical features and diagnostic tests of Cushing's syndrome (CS) of non-iatrogenic etiology, because of there are few similar studies in the last ten years.


METHODS
Fifteen cases of CS were diagnosed from 1992 to 1997 at our hospital. We describe the epidemiological, clinical, biochemical, radiologic, therapeutic and evolutive characteristics.


RESULTS
Both diabetes mellitus and hypertension were observed in 40% of patients. The frequency of etiologies was: Cushing's disease, 66.6%; ectopic ACTH syndrome, 13.3%; adrenal adenoma, 6.6%; adrenal carcinoma, 6.6%; and undiagnosed, 6.6%. The 24-hour urine free cortisol (UFC) and the overnight 1 mg oral dexamethasone suppression test yielded 93.3 and 100% diagnostic sensitivity for CS, respectively. The overnight 8 mg oral dexamethasone suppression test, the metyrapone test and the 7 mg intravenous dexmethasone test had 75, 50 and 60% diagnostic sensitivity for Cushing's disease, respectively. Ketoconazole treatment had success in to normalize the 24-hour UFC in all patients, except for the case of adrenal carcinoma.


CONCLUSIONS
The Cushing's disease was the most common form of CS. The 24-hour UFC and overnight 1 mg oral dexamethasone suppression test were good screening studies. Ketoconazole was successful in normalizing the adrenal cortex function.
Calvo Romero
J M
JM
Servicio de Medicina Interna, Hospital Regional Universitario Infanta Cristina, Badajoz.
Morales Pérez
F
F
Alvarez Barreiro
J A
JA
Diaz Pérez de Madrid
J
J
D000328:Adult; D000368:Aged; D003480:Cushing Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000037:antagonists & inhibitors; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D008797:Metyrapone; D008875:Middle Aged
D003907:Dexamethasone; D007654:Ketoconazole; D006854:Hydrocortisone; D008797:Metyrapone
Síndrome de Cushing: estudio clínico de quince casos.