CLINICAL MANIFESTATIONS OF CUSHING'S DISEASE (RESULTS OF ANALYSIS OF THE CLINICAL DATABASE OF THE MOSCOW REGION)

Background: Cushing's disease (CD) is a  severe multimorbid disorder that affects primarily young people in their productive age. In most cases, the diagnosis is delayed and patients with complications of hypercorticism are seen by doctors of various specialties.

Aim: To identify the most frequent clinical signs and symptoms of CD at the time of diagnosis, to assess an association between clinical manifestations of hypercorticism and main clinical and laboratory parameters.

Materials and methods: We examined 44 CD patients registered in the database of CD patients of the Moscow Regional Research and Clinical Institute (MONIKI).

Results: The mean age of patients was 37.9±10.5 years, with most of them (68.2%) being in the age range of 30 to 50 years. The median of disease duration was 35.5 [22; 75] months. Facial plethora, which is the most characteristic sign of hypercorticism, was seen in 97.7% of patients. Striae, thought to be most often associated with hypercorticism, were found only in 38.6% of patients. The most frequent complaints (> 80%) were weight gain, fatigue, headache, and menstrual dysfunction. Some of the symptoms showed a positive correlation with cortisol levels.

Conclusion: Clinical manifestations of CD are mostly non-specific. Only facial plethora was highly prevalent of all typical symptoms of hypercorticism. At least one of the "specific" symptoms was found in all patients.