Cushing's syndrome: twenty-five years of clinical experience in Navarre

Background. The aim of this work is to determine the situation of Cushing's Syndrome (CS) with respect to aetiology, diagnosis, treatment and cure in the last 25 years in Navarre. Methods. Retrospective, observational study on 36 patients diagnosed with CS between 1985 and 2010. Results. Eighty point five percent were women and 19.5% were men. The average age on diagnosis was 39.3+/-13 years. The main clinical manifestations were: obesity (85.3%), full moon face (35.3%) and myopathy (50%). Aetiologically, in 58.3% the origin was hypophisiary, in 36.1% it was adrenal, and in 5.5% it was ectopic. The UFC average was 343.5+/-310.1 mu g/24hours. Serum cortisol after Nugent test was 15.6+/-8.6 mu g/dl. Low dose plasma cortisol average was 15.1+/-14.2 mu g/dl. There is a statistically significant (p< 0.01) direct lineal correlation between UFC and the Nugent test, as well as between the Nugent test and low dose cortisol test. There are no statistically significant differences between adrenal and hypophisiary aetiology in either demographic factors or analytical results. Treatment in all the hypophisiary and adrenal adenomas was surgical. Twenty-three point eight percent of the hypophisiaries required second surgery and subsequently radiotherapy (RT) and 9.5% only received RT following the first intervention. In the follow-up 52.9% were cured without sequels, 41.1% presented comorbidities and 5.9% died (without significant differences between adrenals and hypophisiaries). Conclusion. The most frequent aetiology of CS was hypophisiary, which was more frequent in women. All of them are cured, although 41.1% presented comorbidities in the follow-up.