Diagnosis and complications of Cushing's disease: gender‐related differences

Zilio, Marialuisa; Barbot, Mattia; Ceccato, Filippo; Camozzi, Valentina; Bilora, Franca; Casonato, Alessandra; Frigo, Anna Chiara; Albiger, Nora; Daidone, Viviana; Mazzai, Linda; Mantero, Franco; Scaroni, Carla

doi:10.1111/cen.12299

Cited by 64 publications

(61 citation statements)

References 25 publications

(24 reference statements)

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“…Several studies have shown that male gender is associated with more severe disease, with a more florid clinical presentation and complications [25,26]. In agreement with this, our initial remission rate for male patients was lower.…”

Section: Discussionsupporting

confidence: 90%

Endoscopic Endonasal Approach for Adrenocorticotropic Hormone-Secreting Pituitary Adenomas: Outcomes and Analysis of Remission Rates and Tumor Biochemical Activity with Respect to Tumor Invasiveness

Shin

Gardner

et al. 2017

World Neurosurgery

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Section: Discussionsupporting

confidence: 90%

Endoscopic Endonasal Approach for Adrenocorticotropic Hormone-Secreting Pituitary Adenomas: Outcomes and Analysis of Remission Rates and Tumor Biochemical Activity with Respect to Tumor Invasiveness

Shin

Gardner

et al. 2017

World Neurosurgery

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“…We had first reported that men with this disorder display a more severe clinical presentation than their female counterparts some 10 years ago (12) and our findings have since been confirmed by other investigators (32,33). Of interest, some of the more severe clinical features in men, e.g osteoporosis and vertebral fractures, can clearly be connected to low testosterone secretion (34).…”

Section: European Journal Of Endocrinologysupporting

confidence: 79%

Gender-dependent changes in haematological parameters in patients with Cushing's disease before and after remission

Ambrogio

Martin

Ascoli

et al. 2014

European Journal of Endocrinology

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Objective: Glucocorticoids stimulate several steps in red blood cell (RBC) development; however, little is known on changes in erythroid parameters in patients with Cushing's disease. The aim of this study was to assess both RBC and white blood cell (WBC) parameters in a large cohort of patients with Cushing's disease and report on alterations in the active phase and after surgical remission. Design and methods: A total of 80 patients with Cushing's disease (63 women and 17 men) were studied before and for up to 254 months' follow-up (mean follow-up 65.8G6.71 months) after pituitary/adrenal surgery. Details of blood counts were reviewed and compared with data obtained from a database of healthy subjects. Results: The RBC counts and haemoglobin levels were low in men with active Cushing's disease (over 80% of values in the lowest quartile) and four patients were overtly anaemic, whereas erythrocyte counts and haemoglobin levels were evenly distributed across the normal range in women with active Cushing's disease. Low erythroid parameters were linked to hypogonadism in men with Cushing's disease. Recovery in erythroid parameters occurred slowly after remission of hypercortisolism in men, in parallel with improvements in testosterone levels. Over 50% of patients with active disease presented increased WBC counts, irrespective of gender, and prompt normalisation within 1 month after surgery. Conclusions: Male patients with Cushing's disease present reduced RBC counts and haemoglobin levels, associated with low testosterone concentrations, which resolve over time after remission of hypercortisolism. Anaemia should therefore be regarded as another unfavourable feature in men with Cushing's disease.

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“…Although speculative, a potential growth-stimulating effect of estrogens on USP8 mutant corticotroph cells in the development of the disease could explain this observation (18). For example, a balanced sex ratio has been reported in unselected pediatric patients (19), with a male predominance under the age of 10 years (20) that turns into a female predominance during adolescence (21,22).…”

Section: Discussionmentioning

confidence: 99%

The Gene of the Ubiquitin-Specific Protease 8 Is Frequently Mutated in Adenomas Causing Cushing's Disease

Pérez-Rivas

Theodoropoulou

Ferraú

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

175

200

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Diagnosis and complications of Cushing's disease: gender‐related differences

Abstract: Although CD is less frequent in male patients, in this gender, it presents with more florid clinical manifestations and may imply more diagnostic difficulties.

Cited by 64 publications

References 25 publications

Endoscopic Endonasal Approach for Adrenocorticotropic Hormone-Secreting Pituitary Adenomas: Outcomes and Analysis of Remission Rates and Tumor Biochemical Activity with Respect to Tumor Invasiveness

Endoscopic Endonasal Approach for Adrenocorticotropic Hormone-Secreting Pituitary Adenomas: Outcomes and Analysis of Remission Rates and Tumor Biochemical Activity with Respect to Tumor Invasiveness

Gender-dependent changes in haematological parameters in patients with Cushing's disease before and after remission

The Gene of the Ubiquitin-Specific Protease 8 Is Frequently Mutated in Adenomas Causing Cushing's Disease

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