Clinical Manifestations Before and After Surgical Treatment in Patients with Endogenous Hypercortisolism

Abstract

Endogenous hypercortisolism (EH) presents varied and complex clinical manifestations (CM) but useful in follow-up. Objective to describe the CM in patients with HE before and after surgery. Material and Methods: Prospective study, cohort of 25 patients with HE, evaluated before and after surgical treatment. Medians and ranges of quantitative variables and frequency distributions of qualitative variables were determined. Cross tabulations of the presence (or not) of symptoms and signs before and after surgery were carried out, using the McNemar test, comparison of medians of quantitative variables before and after surgery using the Wilcoxon test. Results: Cushing's disease predominated (64%). The median age at diagnosis was 45 years and at the time of the study 46 years. Some symptoms that improved after surgery: fatigue (before 64% vs after 36%, p=0.039), weight gain (92% vs 44%, p=0.002), decreased concentration (64% vs 20%, p =0.001), menstrual disorders (76% vs 36% p=0.013). Signs were: bruising (72% vs 16%, p=0.000), moon face (80% vs 40%, p=0.006), buffalo hump (80% vs 48%, p=0.021), supraclavicular fat (68% vs. 40%, p=0.039). The medians of the variables decreased and the difference before and after treatment were statistically significant. Conclusions: In this cohort, all manifestations improved with weakened symptoms after surgical treatment, reaffirming the usefulness of the clinical method for early diagnosis and follow-up of HE.