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Master Thesis

Maladie de Cushing dans le département de la Réunion : prévalence, caractéristiques lors du diagnostic, rémissions et récidives après chirurgie transphénoïdale

Abstract : Objective: to Assess in Reunion Island, prevalence of Cushing's Disease’s (CD) and describe features at diagnosis, remissions and recurrences after transphenoidal surgery (TPS), and efficacy of adjuvant therapies (AT). Methods: multi-centre retrospective study (4 hospitals) from 2005 to 2018. Inclusion criteria : CD defined as Cushing's syndrome and histological confirmation of a corticotropic adenoma, or biochemical resolution of hypercortisolism after TPS. Results: 21 patients were included (BMI 28.8 ± 10.2 kg/m2, age 34.3 ± 12.7 years, female for 66.7%). Prevalence is assessed to be 2.4 per 100,000 inhabitants. At diagnosis, 47.6% of patients had no proteolytic signs ; 31.6% had a moderate hypercortisolism (UFC<2*Upper Limit of normal (ULN)), and UFC value was not correlated with clinical expression intensity. According to Trouillas' classification, 15 adenomas (83.3%) were grade 1a and none grade 2b. In post-operative (PO) period, of the 18 patients included for the recurrence’s evaluation, 16 (89.5%) were in early remission (8h a.m. cortisolemia <5µg/dL within 7 days). 8 patients (50%) relapsed (UFC>ULN) within a period of 28 ± 21 months. The place of birth, the adenoma’s size, the neurosurgeon, or the presence of a PO residue did not modify recurrence rate. At the end of the study, 12 patients (66.7%) experimented long lasting remission, of wich 4 after AT, 2 patients were biochemically controlled (UFC
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https://dumas.ccsd.cnrs.fr/dumas-02100108
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, April 15, 2019 - 3:33:13 PM
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Yaël Rotfus. Maladie de Cushing dans le département de la Réunion : prévalence, caractéristiques lors du diagnostic, rémissions et récidives après chirurgie transphénoïdale. Médecine humaine et pathologie. 2019. ⟨dumas-02100108⟩

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