Thyroid function in children with Cushing's disease before and after transsphenoidal surgery

Area of Science:

• Pediatric Endocrinology
• Endocrinology
• Neurosurgery

Background:

• Cushing's disease (CD) in children can impact growth and thyroid function.
• The effects of CD and its treatment on thyroid status in pediatric populations are not well-understood.

Purpose of the Study:

• To investigate thyroid function and its correlation with growth parameters in children and adolescents with Cushing's disease treated with transsphenoidal surgery (TSS).

Main Methods:

• Prospective follow-up of 24 children and adolescents with CD post-TSS.
• Evaluation of thyroid function tests (free thyroxine, T3, TSH) before and at 3, 6, and 12 months after surgery.
• Correlation analysis between thyroid function and body weight, BMI, and bone age.

Main Results:

• Preoperative free thyroxine was higher than at 3 months post-TSS, while T3 and TSH were lower preoperatively compared to postoperative values.
• A mild, transient suppression of thyroid function was observed in most patients in the early postoperative period.
• Hypothyroidism was an infrequent complication, affecting only a few patients, and did not correlate with growth or obesity parameters.

Conclusions:

• Mild thyroid function suppression is common in pediatric Cushing's disease patients before and shortly after transsphenoidal surgery.
• Significant hypothyroidism is a rare complication of CD and TSS in children and adolescents.
• Thyroid function normalized within 6 months post-surgery and did not influence growth delay or obesity in this cohort.