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Diagnosis and treatment of Cushing's disease in children

Martin O Savage, Renuka P Dias, Li F Chan

    Endocrine Development
    |December 4, 2009
    PubMed

    Insights

    Cushing's disease (CD) in children is rare and challenging to diagnose and treat. Management requires specialized protocols and long-term follow-up for growth, bone health, and other health aspects into adulthood.

    Area of Science:

    • Pediatric Endocrinology
    • Endocrinology
    • Rare Diseases

    Background:

    • Cushing's disease (CD) is uncommon in pediatric patients, posing significant diagnostic and therapeutic challenges.
    • Paediatric endocrinologists often lack extensive experience with pediatric CD, necessitating collaboration with adult specialists.
    • Existing diagnostic and management protocols for adult CD require adaptation for the pediatric population.

    Purpose of the Study:

    • To outline a diagnostic protocol for pediatric Cushing's disease.
    • To critically appraise current treatment strategies for pediatric CD.
    • To address the long-term management challenges following cure in pediatric CD patients.

    Main Methods:

    • Review and adaptation of adult diagnostic protocols for pediatric use.
    • Critical appraisal of established and emerging treatment modalities for CD.
    • Analysis of long-term outcomes including growth, bone health, reproduction, and body composition.

    Main Results:

    • A diagnostic protocol, adapted from adult models, is essential for pediatric CD investigation.
    • Treatment strategies require careful consideration of the pediatric context and long-term implications.
    • Post-cure management is crucial for optimizing growth, bone health, reproductive potential, and body composition into adulthood.

    Conclusions:

    • Pediatric Cushing's disease necessitates specialized diagnostic and therapeutic approaches.
    • Collaboration between pediatric and adult endocrinology is beneficial for managing this rare condition.
    • Long-term multidisciplinary follow-up is critical for ensuring optimal health outcomes for pediatric CD survivors.

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