Hypercoagulable state in Cushing's syndrome is reversible following remission.
OBJECTIVE
Hypercoagulability is a commonly described complication in patients with Cushing's syndrome (CS). The aim of this study was to assess the long-term effects of surgical remission from CS on serum levels of coagulation and fibrinolytic markers.


METHODS
Eighteen patients with active CS (16 women, 2 men; age: 38.6 ± 13.7 years) were enrolled in the study. We measured serum levels of coagulation and fibrinolytic markers during active CS and 6 months after remission. The control group comprised 18 age- and sex-matched healthy individuals.


RESULTS
Six months after remission from CS, patients had lower levels of factors II (P < 0.001), V (P = 0.02), XI (P = 0.04) and XII (P < 0.001), protein C (P < 0.001), protein S (P = 0.002), antithrombin (P = 0.03), antithrombin Ag (P = 0.008), plasminogen (P = 0.03) and C1 inhibitor (P = 0.001), and aPTT was longer than at enrollment (P = 0.001). Levels of PAI-1 and factors VII, VIII and IX tended to normalize, but there were no significant differences in these parameters before and after surgery, nor were differences found in haemostatic and fibrinolytic markers between the patients in remission and control individuals, except for factor XII (P = 0.02) and protein C (P = 0.004), which were lower among patients in remission.


CONCLUSIONS
Six months after remission from CS, patients' risk of thromboembolism is comparable to that of healthy individuals.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Darko
D
Kastelan
Tina
T
Dusek
Ivana
I
Kraljevic
Izet
I
Aganovic
D000328:Adult; D003480:Cushing Syndrome / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D013923:Thromboembolism / Q000378:metabolism / Q000503:physiopathology; D019851:Thrombophilia / Q000378:metabolism* / Q000503:physiopathology
D017395:Plasminogen Activator Inhibitor 1