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Long-term morbidity and mortality in patients with Cushing's syndrome
Leah T Braun1, Frederick Vogel1, Martin Reincke1
1Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany.
Insights
Cushing's syndrome significantly increases risks for hypertension, diabetes, and infections, leading to high mortality, especially from cardiovascular events. Long-term interdisciplinary management is crucial for reducing patient morbidity and mortality.
Area of Science:
- Endocrinology
- Internal Medicine
- Clinical Research
Background:
- Cushing's syndrome presents significant multisystem challenges.
- Patients face clinical problems during diagnosis and remission.
- High morbidity and mortality rates are associated with this condition.
Purpose of the Study:
- To highlight the clinical problems and challenges in Cushing's syndrome.
- To emphasize the need for optimized therapy recommendations.
- To underscore the importance of interdisciplinary management.
Main Methods:
- Review of clinical problems and comorbidities in Cushing's syndrome.
- Analysis of mortality risks and causes.
- Discussion of current therapy recommendations and research gaps.
Main Results:
- Key comorbidities include hypertension, diabetes, overweight, and myopathy.
- High risks for infections and venous thromboembolism are noted.
- Mortality is highest during active disease and the first year post-diagnosis, driven by cardiovascular events, infections, and suicide.
Conclusions:
- Interdisciplinary therapy management is vital for long-term reduction of morbidity and mortality.
- Further prospective studies are needed to optimize existing therapy recommendations.
- Addressing comorbidities proactively is essential for improving patient outcomes.
Abstract:
Increased multisystem morbidity and mortality in patients with Cushing's syndrome comprise clinical problems and challenges, both at the time of diagnosis and in remission. Relevant comorbidities and clinical problems include hypertension, diabetes, overweight, myopathy and a high risk for acute complications such as infections and venous thrombembolism. Although there are therapy recommendations for most of these comorbidities, there is a lack of large, prospective studies to confirm and optimise them. Mortality is especially high during active disease and within the first year after diagnosis, as a result of cardiovascular events, infections and suicide. All in all, interdisciplinary therapy management is important for reducing morbidity and mortality over the long-term.
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