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Publication Type
Journal Article
Author, Analytic
Wright-Pascoe, Rosemarie A.; Charles, C. F.; Richards, R.; Fletcher, Peter R.; Hanchard, Barrie; Kelly, D.
Author Affiliation, Ana.
Department of Medicine
Article Title
A clinico-pathological study of Cushing's syndrome at the University Hospital of the West Indies and a review of the literature
Medium Designator
n/a
Connective Phrase
n/a
Journal Title
West Indian Medical Journal
Translated Title
n/a
Reprint Status
n/a
Date of Publication
2001
Volume ID
50
Issue ID
1
Page(s)
55-61
Language
eng
Connective Phrase
n/a
Location/URL
n/a
ISSN
0043-3144
Notes
n/a
Abstract
Cushing's syndrome is an uncommon but important disease. Twenty-one confirmed cases of spontaneous Cushing's syndrome were documented at the University Hospital of the West Indies over a 21-year period. They were predominantly young females (F:M ratio of 17:4; mean age 25 years and 3 months). The commonest presenting symptoms were amenorrhoea (41%) and obesity (19%). Common clinical features were cushingnoid features (95%), hypertension (76%) and hirsutism (82%). Twenty-nine per cent had frank hyperglycaemia. Cushing's syndrome was due to Cushing's disease in 10 cases, adrenal adenoma in 3 and adrenal carcinoma in 2 cases. In 4 cases with presumed adrenal hyperplasia, the histology was either unavailable or was not consistent with the diagnosis. Two cases appear now to have had the ectopic ACTH Syndrome. Adrenalectomy was the commonest treatment offered. There were no intra-operative or post-operative deaths but recurrence was common after subtotal adrenalectomy in Cushing's disease. Twenty-seven per cent of the patients developed Nelson's syndrome, which was fatal in 50%. Long-term hormone replacement therapy was unnecessary after surgery for adrenal adenomas. Treatment of Cushing's syndrome was well tolerated by the patients.....
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