Cushing disease: Morbidity and mortality analysis associated with patients of Centro Médico Docente la Trinidad

Abstract

Summary: Cushing disease is the main cause of neoplastic endogenous hypercortisolism. Of the tumor registry of the Centro Médico Docente La Trinidad consultation, we analyzed the morbimortality. Methods and Materials:  it's an observational, descriptive, retrospective, cross- sectional study. Twelve patients diagnosed with Cushing's disease between 2017-2020. Results: the majority of patietns were female with an average age of 35,75±10,17, The most frequent discriminative clinical characteristics were easy bruising, violaceous striae, depression and facial plethora, of the non-discriminative ones the most frequent were hirsutism, female baldness, weight gain/obesity and dorsocervical hump. About the diagnosis there was an increase of >36 μg/dl of serum cortisol in 40% qualifying as Severe Cushing; 40% had 24 hour urinary free cortisol 4 times the upper normal value (UNV), 30% between 1.5 and 2.7 times the UNV; 83,33% suppressed with the dexamethasone test, 5 patients had ACTH values between 6-76 pg/ml and four >76pg/mL, 82% were microadenomas and 75% were seen in surgery and at macroscopic analysis in pathology report. Transsphenoidal surgery) was performed in 66,66%, complications were CSF fistula, 25% permanent diabetes insipidus and 25% had intraoperative hemorrhage. Cushing's Disease recurrence was observed in 41,6%, persistence in 33,33%, clinically significant partial improvement in 25%, complete remission in 25% and death in 1/12 patients due to diabetes insipidus.Conclusions: initial severe presentation of Cushing’s disease is usual, early treatment could reduce the level of severity that the patients with Cushing's disease develop to prevent complications.