Klinička obilježja i ishod liječenja bolesnika s Cushingovom bolesti

master's thesis

• Title (english): Clinical features and therapeutic outcomes in patients with Cushing's disease
• Author: Jelena Krešić
• Mentor: Tina Dušek (mentor)
• Committee member: Darko Kaštelan (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

CILJ RADA:
Cilj ovog rada je procijeniti učestalost dijabetesa melitusa, hipertenzije, prijeloma kosti ili osteoporoze, pojačane dlakavosti, hematoma te povećane tjelesne težine pri postavljanju dijagnoze Cushingova sindroma kod pacijenata hospitaliziranih od svibnja 2011. godine do lipnja 2014. godine na Zavodu za endokrinologiju Klinike za unutrašnje bolesti KBC-a Zagreb. Te procijeniti uspješnost kirurškog liječenja Cushingova sindroma kod istih pacijenata.
METODE:
Analizirani su podaci 29 ispitanika sa Zavoda za endokrinologiju Klinike za unutrašnje bolesti KBC-a Zagreb, koji su uključeni u Europski registar Cushingova sindroma.
REZULTATI:
Prosječna dob pacijenata je bila 45 ± 13.2 godine (5 muškaraca). Kod 16 pacijenata postavljena je dijagnoza Cushingove bolesti, 12 pacijenata je imalo ACTH-neovisni oblik bolesti, a kod jedne pacijentice sumnja se na ektopični izvor lučenja ACTH. Pri postavljanju dijagnoze Cushingova sindroma, 86% ispitanika je imalo hipertenziju (prosječne vrijednosti sistoličkog tlaka bile su 141 ± 18.6 mmHg, a dijastoličkog 91.4 ± 9.2 mmHg). Kod 38% ispitanika bio je dijagnosticiran dijabetes, a 24% je imalo prijelom kosti ili dijagnosticiranu osteoporozu. 66% ispitanika prezentiralo se s pojačanom dlakavosti, a 76% s lakim nastajanjem hematoma kože. Do porasta tjelesne težine došlo je kod 62% ispitanika. Prosječna vrijednost indeksa tjelesne mase bila je 27.2 ± 7.3 kg/m². 41% bolesnika je bilo s prekomjernom tjelesnom težinom, a 31% pretilih. Kod 87.5% pacijenata s Cushingovom bolesti liječenih u KBC-u Zagreb i kod svih pacijenata s ACTH-neovisnim oblikom je došlo do remisije bolesti nakon kirurškog liječenja.
ZAKLJUČAK:
Ovim istraživanjem je nađeno da su hipertenzija, lako stvaranje hematoma i pojačana dlakavost najčešći znakovi i simptomi kod bolesnika koji boluju od Cushingova sindroma.

Abstract (english)

AIM:
The aim of this study was to estimate the prevalence of diabetes, hypertension, bone fractures or osteoporosis, hirsutism, hematoma, and increased body weight while diagnosing Cushing's syndrome in patients hospitalized since May 2011 until June 2014 in the Department of Endocrinology, Department of Internal Medicine KBC Zagreb. Additionally, the study has assessed effectiveness of surgical treatment of Cushing's syndrome in the same patients.
METHODS:
Data from 29 patients hospitalized in the Department of Endocrinology, Department of Internal Medicine KBC Zagreb and included in The European Registry on The Cushing's syndrome was analyzed.
RESULTS:
The average age of patients was 45 ± 13.2 years (5 male), 16 of them were diagnosed with Cushing's disease, 12 with ACTH-independent form of the disease, and in one patient ectopic ACTH secretion is suspected. When the diagnosis of Cushing's syndrome was established, 86% had hypertension (mean systolic blood pressure was 141 ± 18.6 mmHg and diastolic 91.4 ± 9.2 mmHg) 38% of patients were diagnosed with diabetes, and 24% had a bone fracture or osteoporosis diagnosed. 66% of patients presented with hirsutism, and 76% with easy skin hematoma formation. An increase in body weight occurred in 62% of patients. The average value of the body mass index was 27.2 ± 7.3 kg / m². 41% of patients were overweight and 31% obese. In 87.5% of patients with Cushing's disease treated at the hospital in Zagreb and in all patients with ACTH-independent form, remission occurred after surgical treatment.
CONCLUSION:
This study found that hypertension, easy skin hematoma formation and hirsutism are the most common signs and symptoms in patients with Cushing's syndrome.

• Keywords: Cushingov sindrom; Cushingova bolest; hipertenzija; dijabetes melitus; osteoporoza; pojačana dlakavost; hematomi; porast tjelesne težine
• Keywords (english): Cushing's syndrome; Cushing's disease; hypertension; diabetes mellitus; osteoporosis; hirsutism; hematoma; increase in body weight
• Language: croatian
• URN:NBN: urn:nbn:hr:105:396875
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-22 09:26:04