Demographic Factors and the Presence of Comorbidities do not Promote Early Detection of Cushing's Disease and Acromegaly

Psaras, Tsambika; Milian, Monika; Hattermann, V; Freiman, Thomas M.; Gallwitz, Baptist; Honegger, Juergen

doi:10.1055/s-0030-1263104

Cited by 21 publications

(33 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These pathognomonic signs can be detected by face classification software and could hypothetically be used for early diagnosis. Recent studies have found that CS is currently diagnosed with a latency of about 2-6 years (1,2). This may partly be due to an overlap of clinical features with the more common metabolic syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…This may partly be due to an overlap of clinical features with the more common metabolic syndrome. Acromegaly is still diagnosed with a delay of about 6 years, most likely due to the slow progression of symptoms (2,3). To reduce the diagnostic delay and improve disease outcomes, new sensitive and simple screening methods and increased awareness for these diseases are needed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic use of facial image analysis software in endocrine and genetic disorders: review, current results and future perspectives

Kosilek

Frohner

Würtz

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

Cushing's syndrome (CS) and acromegaly are endocrine diseases that are currently diagnosed with a delay of several years from disease onset. Novel diagnostic approaches and increased awareness among physicians are needed. Face classification technology has recently been introduced as a promising diagnostic tool for CS and acromegaly in pilot studies. It has also been used to classify various genetic syndromes using regular facial photographs. The authors provide a basic explanation of the technology, review available literature regarding its use in a medical setting, and discuss possible future developments. The method the authors have employed in previous studies uses standardized frontal and profile facial photographs for classification. Image analysis is based on applying mathematical functions evaluating geometry and image texture to a grid of nodes semi-automatically placed on relevant facial structures, yielding a binary classification result. Ongoing research focuses on improving diagnostic algorithms of this method and bringing it closer to clinical use. Regarding future perspectives, the authors propose an online interface that facilitates submission of patient data for analysis and retrieval of results as a possible model for clinical application.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic use of facial image analysis software in endocrine and genetic disorders: review, current results and future perspectives

Kosilek

Frohner

Würtz

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…All of these complications may induce a decrease in social functioning and working abilities of CD patients, resulting in an overall severe handicap. The mean time period from onset of symptoms and comorbidities to the final diagnosis of the disease is on average 6 years [11] and the considerable delay until disease detection has an unfavourable influence concerning the complete restitution of accompanying comorbidities and damages.…”

Section: Introductionmentioning

confidence: 99%

Tuebingen CD-25 Is a Sensitive Tool to Investigate Health-Related Quality of Life in Cushing's Disease Patients in the Course of the Disease

Milian¹,

Honegger²,

Teufel³

et al. 2013

Neuroendocrinology

View full text Add to dashboard Cite

Background: The primary object was to investigate whether the Tuebingen CD-25 captures changes in health-related quality of life (HRQoL) sensitively in Cushing's disease (CD) and to identify factors that favour postoperative HRQoL. Methods: 17 CD patients were scheduled for transsphenoidal tumour removal and filled out the inventory before and after surgery. The mean time elapsed after surgery was 14.4 ± 11.3 months. All patients were in remission at the second timepoint of investigation. Results: HRQoL as assessed with the Tuebingen CD-25 improved significantly after successful surgical tumour removal. A large effect size (Cohen's d = 0.84) in the total score indicates good sensitivity to change. 13 patients (76.5%) showed impaired HRQoL preoperatively compared with a general population sample. Postoperatively, 35.3% of the patients still suffered from an impaired HRQoL. Stepwise linear regression analysis revealed that less comorbidities (≤2) and greater morning cortisol decrease were promotive factors for better postoperative HRQoL (p < 0.05). The postoperative improvement in HRQoL could be best predicted by the presence of preoperative HRQoL impairment and age of the patients, i.e. patients who were younger were more likely to improve. Moreover, patients without postoperative pituitary deficiencies improved significantly more in the cognition scale. A tendency towards more improvement in overall HRQoL was observed in non-hypocortisolaemic patients. Conclusions: The Tuebingen CD-25 has proved to be a capable and sensitive instrument to investigate HRQoL in the course of disease. The number of postoperative comorbidities had the greatest impact on postoperative well-being.

show abstract

“…İtalya'da yapılan 300 hastanın katıldığı çok merkezli bir çalışmada, CS ile ilişkili ilk belirtinin ortaya çıkmasından 2 yıldan biraz daha fazla bir süre sonra CS tanısı konulabildiği bildirilmiştir (8). Otuz üç CS'li hastanın katıldığı başka bir klinik çalışmada CS tanı süresinin ortalama 6 yıl olduğu bulunmuştur (9). Bu çalışmada ilk semptomun başlangıcından tanı konulmasına kadar geçen sürenin hasta ile ilgili faktörlerden (cinsiyet, yaş, eğitim durumu, kırsal ya da kentsel yerleşim) etkilenmediği, birinci basamak sağlık kuruluşundaki hekimin CS'den haberdarlığı ile yakından ilişkili olduğu bulunmuştur (9).…”

Section: Discussionunclassified

“…Otuz üç CS'li hastanın katıldığı başka bir klinik çalışmada CS tanı süresinin ortalama 6 yıl olduğu bulunmuştur (9). Bu çalışmada ilk semptomun başlangıcından tanı konulmasına kadar geçen sürenin hasta ile ilgili faktörlerden (cinsiyet, yaş, eğitim durumu, kırsal ya da kentsel yerleşim) etkilenmediği, birinci basamak sağlık kuruluşundaki hekimin CS'den haberdarlığı ile yakından ilişkili olduğu bulunmuştur (9). Bu nedenle klinisyenlerin özellikle diyabet, hipertansiyon ve osteoporoz gibi hastalıkların beklenen yaştan erken oluşması ve bizim olgumuzda olduğu gibi daha şiddetli seyretmesi durumlarında CS varlığı açısından uyanık olmaları gerekmektedir.…”

Section: Discussionunclassified

A Case of Cushing’s Syndrome Presented with Severe Heart Failure and Multiple Vertebral Fractures

Arduç¹,

Işık²,

Akbaba³

et al. 2015

Haseki

View full text Add to dashboard Cite

ÖzetCushing sendromunda (CS) kardiyovasküler hastalıklar ve osteoporoz nedeni ile mortalite ve morbidite artmaktadır. Klinik bulgular ve mortalite hiperkortizoleminin şiddeti ve süresi ile ilişkilidir. Biz CS tanısının gecikmesinden kaynaklanan ciddi komplikasyonlarla başvuran bir olguyu sunduk. Elli iki yaşındaki erkek hasta bacaklarda şişlik, nefes darlığı ve bel ağrısı şikayetleri ile başvurdu. Özgeçmisinde 2 yıldır çoklu antihipertansif tedavi ve yoğun insülin tedavisine rağmen kontrol altına alınamayan hipertansiyon ve diyabet ile 6 aydır kalp yetmezliği mevcuttu. Fizik muayenede pletore, bufalo hörgücü, abdominal obezite, karında mor strialar, pretibial ödem saptandı. Laboratuvar incelemesinde adrenokortikotropik hormon (ACTH) <5 pg/ml, sabah plazma kortizolü 26,33 µg/dl, gece plazma kortizolü 26,38 µg/dl, idrar kortizolü 272 µg/24 saat saptandı. Klasik 2 mg ve 8 mg deksametazon supresyon testlerinde plazma kortizolünde baskılanma yoktu (sırası ile 30,7 µg/dl ve 35,54 µg/dl). Ekokardiyografide ejeksiyon fraksiyonu düşük (%40) ölçüldü, direkt grafide vertebralarda kompresyon fraktürleri mevcuttu. Adrenal CT'de sol sürrenalde 4x4 cm boyutlarında adenom ile uyumlu lezyon mevcuttu. Adrenal kaynaklı CS tanısı ile sol surrenalektomi yapıldı ve patolojik incelemede adrenokortikal adenom saptandı. Operasyon sonrası hastanın diyabet, hipertansiyon ve osteoporozunda kısmi düzelme oldu. Vertebra fraktürlerine yönelik operasyon planlandı. Diyabet ve hipertansiyon gibi hastalıkların daha şiddetli seyretmesi ve tedaviye dirençli olmaları durumunda klinisyenin CS varlığı açısından uyanık olması gerekmektedir. Tanının gecikmesi mortalite ile sonuçlanabilecek ağır komplikasyonlara yol açabilir. (Ha se ki T›p Bül te ni 2015; 53: 256-9)Anahtar Sözcükler: Cushing sendromu, kalp yetmezliği, vertebra kırığı Abs tractCushing's syndrome (CS) is associated with increased morbidity and mortality due to cardiovascular diseases and osteoporosis. Clinical findings and mortality are related to degree and duration of hypercortisolism. We report a patient with CS who presented with severe complications resulting from delayed diagnosis. A 52-year-old male with a two-year history of uncontrolled diabetes mellitus and hypertension and a six-month history of heart failure was admitted with leg edema, dyspnea, and back pain. His physical examination revealed plethora, abdominal obesity, and abdominal purple striae. Laboratory analysis revealed the following results: adrenocorticotropic hormone: <5 pg/ml, morning plasma cortisol: 26.33 µg/dl, night plasma cortisol: 26.38 µg/dl, and urine cortisol: 272 µg/24 hour. No suppression was detected in the plasma cortisol of 2 mg and 8 mg dexamethasone suppression tests (30.7 µg/ dl and 35.54 µg/dl, respectively). Echocardiography showed low ejection fraction (40%), X-ray demonstrated vertebral fractures. Adrenal CT revealed a 4x4 cm left adrenal mass. The patient underwent left adrenalectomy. Histopathological diagnosis was adrenocortical adenoma. After the operation, a partial recovery was detected i...

show abstract

Demographic Factors and the Presence of Comorbidities do not Promote Early Detection of Cushing's Disease and Acromegaly

Cited by 21 publications

References 13 publications

Diagnostic use of facial image analysis software in endocrine and genetic disorders: review, current results and future perspectives

Diagnostic use of facial image analysis software in endocrine and genetic disorders: review, current results and future perspectives

Tuebingen CD-25 Is a Sensitive Tool to Investigate Health-Related Quality of Life in Cushing's Disease Patients in the Course of the Disease

A Case of Cushing’s Syndrome Presented with Severe Heart Failure and Multiple Vertebral Fractures

Contact Info

Product

Resources

About